Lupus最新文献

{"title":"Lower-dose glucocorticoid therapy achieves comparable outcomes in Japanese patients with lupus nephritis.","authors":"Yoshiyuki Abe, Ayako Makiyama, Kentaro Minowa, Saki Uchiyama, Masahiro Kogami, Motoki Takeuchi, Yoshiya Tanaka, Keiju Hiromura, Hiroki Hayashi, Kazuro Kamada, Yutaka Kawahito, Akiho Iwashita, Shinya Kaname, Hayato Shimizu, Shinsuke Yasuda, Kazuoto Hiramoto, Shoichi Maruyama, Nobuyuki Yajima, Yasunori Iwata, Isao Matsumoto, Takahisa Gono, Hiroko Sato, Satoshi Kubo, Hidekazu Ikeuchi, Yukio Yuzawa, Michihito Kono, Takahiro Seno, Akira Onishi, Takahisa Kawakami, Tadashi Hosoya, Yuko Kaneko, Sawako Kato, Shiori Nakagawa, Yuya Kondo, Masataka Kuwana, Tomonori Ishii, Tatsuya Atsumi, Koichiro Ohmura, Naoto Tamura","doi":"10.1177/09612033261449985","DOIUrl":"https://doi.org/10.1177/09612033261449985","url":null,"abstract":"<p><p>ObjectiveTo evaluate the effectiveness of a lower initial glucocorticoid (GC) dose (0.4-0.6 mg/kg/day) compared to the conventional dose (0.8-1.2 mg/kg/day) in achieving complete renal response (CRR) at 12 months in Japanese patients with proliferative lupus nephritis (LN).MethodsThis multicentre, retrospective observational study analyzed data from 344 Japanese patients diagnosed with LN (class III or IV ± V) via renal biopsy. Patients were divided into two groups based on their initial dose of GC. 1:1 propensity score matching (PSM) based on key baseline variables, 23 patients were included in each group. The primary endpoint was CRR at 12 months, defined according to the BLISS-LN trial criteria. A non-inferiority margin of -10% was prespecified.ResultsAfter PSM, the CRR rate at 12 months was 87.0% in the low-dose group and 73.9% in the conventional-dose group (risk difference: 13.1%; 95% confidence interval [CI]: -9.4% to 35.6%), confirming statistical non-inferiority. While GC doses differed significantly during the initial 3 months, they became comparable between the groups after 6 months.ConclusionA reduced initial GC dose of 0.4-0.6 mg/kg/day achieved renal outcomes comparable to conventional dosing in Japanese patients with LN. Given the risks of GC toxicity, these findings may support the potential for lower-dose GC strategies in LN treatment.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261449985"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity and mortality in primary versus secondary antiphospholipid syndrome: A single-center study using the 2023 ACR/EULAR criteria.","authors":"Roni Meidan, Monica Angerri Nadal, Blanca Viejo Sosa, Uxia Couto Lareo, Prabal Mittal, Hannah Cohen, David Isenberg","doi":"10.1177/09612033261449991","DOIUrl":"https://doi.org/10.1177/09612033261449991","url":null,"abstract":"<p><p>ObjectiveTo evaluate differences in morbidity and mortality between patients with primary antiphospholipid syndrome (PAPS) and APS secondary to systemic lupus erythematosus (SAPS), classified according to the 2023 ACR/EULAR APS criteria.MethodsA single-center retrospective observational study including consecutive adult patients evaluated for suspected APS, retrospectively classified according to the 2023 ACR/EULAR APS criteria. Those patients who were included were categorized as SAPS based on the presence of concomitant SLE, defined using the 2012 Systemic Lupus International Collaborating Clinics criteria. Demographic, clinical, laboratory, and outcome data were extracted from medical records. Group comparisons were performed using t-tests, chi-square or Fisher's exact tests. Multivariable Cox regression was used to identify factors associated with mortality.ResultsOf 432 patients who were screened, 210 (48.6%) fulfilled the 2023 ACR/EULAR criteria and were included, comprising 151 (71.9%) with PAPS and 59 (28.1%) with SAPS. Compared with PAPS, SAPS patients were more frequently female (91.7% vs 65.6%, p < 0.001), of younger age at first APS-related event (34.2 vs 43.1 years, p < 0.001), and had a higher prevalence of renal disease (33. 9% vs 6.0%, p < 0.001). Rates of venous, arterial, recurrent thrombosis, and obstetric manifestations were similar between groups. CAPS and overall mortality were higher in SAPS (11.9% vs 2.7%, p = 0.01; 22.0% vs 10.6%, p = 0.045, respectively). In multivariable Cox regression, increasing age at first event, SAPS, and renal disease were independently associated with increased mortality (adjusted HR 1.1, 5.28, and 3.16, respectively).ConclusionSAPS is associated with higher mortality and increased CAPS risk, emphasizing the adverse prognostic impact of concomitant SLE and the need for tailored risk stratification.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261449991"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with changes in self-efficacy in patients with systemic lupus erythematosus. Data from the almenara lupus cohort.","authors":"Alvaro M Ñaña-Cordova, Zulema Mamani-Condori, Itala Jordan-Beisaga, Valeria L Reyna-Ruiz, Rocío V Gamboa-Cardenas, Victor Pimentel-Quiroz, Cristina Reátegui-Sokolova, Samira García-Hirsh, Zoila Rodriguez-Bellido, Cesar Pastor-Asurza, Risto Perich-Campos, Graciela S Alarcón, Manuel F Ugarte-Gil","doi":"10.1177/09612033261449978","DOIUrl":"https://doi.org/10.1177/09612033261449978","url":null,"abstract":"<p><p>AimTo evaluate the factors associated with changes in self-efficacy in systemic lupus erythematosus (SLE) patients from a prevalent cohort.MethodsMembers of the Almenara Lupus Cohort who had entered it between 2018 and 2024 were included. Sociodemographic variables were collected. Self-efficacy was examined with the five domains of the PROMIS self-efficacy for the management of chronic conditions' instrument and general self-efficacy. The Short Form (SF)-36 health questionnaire' [physical and mental component summary measures (PCS and MCS)] was obtained. Disease activity was ascertained with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and damage with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Therapeutic variables included the use of antimalarials and of immunosuppressants as well as the daily prednisone dose. Generalized estimating equations were performed using general self-efficacy and the five domains for chronic disease management as outcomes.Results331 patients were included; their mean age at diagnosis was 35.1 (SD = 13.7) years and 91.5% their disease duration at baseline was 10.3 (SD = 7.49) years; (<i>n</i> = 303) were women; 97.9% were Mestizo. Factors associated with a better general self-efficacy were White ethnicity (β = 7.09, SE = 1.14, <i>p</i> < 0.001), being currently employed (β = 1.09, SE = 0.53, <i>p</i> = 0.038), PCS (β = 0.08, SE = 0.02, <i>p</i> < 0.001), and previous general self-efficacy (β = 0.39, SE = 0.05, <i>p</i> < 0.001). In contrast, Black ethnicity (β = -2.06, SE = 0.56, <i>p</i> < 0.001 and daily prednisone dose (β = -0.13, SE = 0.02, <i>p</i> < 0.001) were negatively associated with general self-efficacy.ConclusionsFactors associated with general self-efficacy improvement were higher previous self-efficacy, White ethnicity, being currently employed and having a better HRQoL In contrast, Black ethnicity and higher daily prednisone dose predisposed to general self-efficacy worsening.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261449978"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood systemic lupus erythematosus with lupus myositis: A report of 6 cases.","authors":"Gu Yuxuan, Chen Xin, Chen Zhiguo, Huang Yuchan, Wang Xinlei, Miao Jialei, Liu Ling, Li Chunzhen","doi":"10.1177/09612033261445771","DOIUrl":"https://doi.org/10.1177/09612033261445771","url":null,"abstract":"<p><p>ObjectiveTo investigate the clinical characteristics of pediatric systemic lupus erythematosus complicated by myositis.MethodsA retrospective analysis was conducted on the clinical data of six patients with SLE-associated myositis, examining manifestations of multisystem involvement, muscle injury markers, and autoantibody profiles.ResultsAmong the six patients, five were female and one male, with a median age of 12 years. All patients presented with myalgia and/or muscle weakness. Physical examination revealed muscle weakness (grade 2-4) in all six children, with bilateral lower limb myalgia in 4. Laboratory findings showed elevated creatine phosphokinase levels ranging from 217 to 3317 U·L^-1 in four patients. All patients also exhibited elevated lactate dehydrogenase levels, ranging from 293 to 949 U/L. After treatment, clinical symptoms resolved in all patients, with the majority achieving stable conditions. Only one case experienced recurrence due to inappropriate drug tapering, which resolved following readmission and intensive treatment.ConclusionMyositis is not a common feature of SLE. Patients with SLE complicated by myositis should complete relevant investigations at the earliest opportunity. Early diagnosis and stratified individualized treatment can effectively control the disease.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261445771"},"PeriodicalIF":1.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The intervention to improve quality of life for African American lupus patients project: Incorporating the element of choice to improve disease self-management and quality of life: A randomized controlled study.","authors":"Edith M Williams, Jerik Leung, Larisa Bruner, Jiajia Zhang, Jie Zhou, Jim C Oates","doi":"10.1177/09612033261432151","DOIUrl":"10.1177/09612033261432151","url":null,"abstract":"<p><p>BackgroundThe Intervention to Improve Quality of life for African American lupus patients (IQAN) Project is a three armed randomized, wait list-controlled trial focused on providing a variety of self-management tools to participants. We focus on African American individuals with lupus due to the increased morbidity and mortality in this population.PurposeTo examine whether a unique 'a-la-carte' self-management program improved quality of life, decreased depression, and reduced perceived and biological indicators of stress in African American lupus patients.MethodsIndividualized intervention plans (IIP's) offered 1-4 options, including a mail-delivered arthritis kit, message board, support group, and enrollment in a self-management program. A 'set menu' control condition included a standardized chronic disease self-management program only, and a control condition was usual care (UC). Validated measures of stress, depression, and quality of life were collected in all patients before and after intervention activities. To evaluate changes between baseline and post-intervention, compact scores were compared across groups, using two-sample t-tests.ResultsImprovements were observed in areas of stress management and pain management (<i>p</i> = 0.05). The frequency of managing pain by applying positive techniques increased in the intervention group (<i>p</i> = 0.08), but the other two groups did not display such improvements. An increasing trend persisted in the intervention group in the frequency of applying stress management techniques (<i>p</i> = 0.02) and decreasing trends in activity limitation were observed in both the intervention and set-menu control groups.ConclusionsBetter self-management outcomes were observed when participants were able to dictate the content or pace of the intervention program. This suggests that self-selection of program components has the potential to improve disparate trends in quality of life, disease activity and stress among African American lupus patients, which could impact future research and policy decisions.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"581-591"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression levels of miR-146a-5p, miR-155-5p and the pro-inflammatory cytokine IL-8 in pregnant women with anti-phospholipid syndrome.","authors":"Mai M Shaker, Nesma M Elaraby, Taghreed A Shalabi","doi":"10.1177/09612033261430573","DOIUrl":"10.1177/09612033261430573","url":null,"abstract":"<p><p><b>Background:</b> Anti-phospholipid syndrome (APS) is systemic autoimmune disorder defined as presence of anti-phospholipid antibodies with multiple obstetric complications. miR-146a-5P and miR-155-5P regulate APS and its associated inflammatory cytokines. <b>Purpose:</b> Our aim is to study expression levels of miR-146a-5p, miR-155-5p and pro-inflammatory cytokine interleukin-8 (IL-8) among pregnant females having APS. <b>Research design:</b> It is a case-control study. <b>Data Collection and Analysis:</b> Case group consisted of 50 pregnant women having APS. Control group consisted of 50 healthy pregnant women. Expression levels of miR-146a-5p and miR-155-5p were determined by quantitative reverse transcription polymerase chain reaction method (qPCR). IL-8 levels were determined using enzyme-linked immunosorbent assay (ELISA). <b>Results:</b> miR-146a-5p (mean ± SD), p value (confidence interval (CI)) among APS group versus Control group = (0.95 ± 0.7) versus (0.27 ± 0.4); 0.01 (0.44-0.90). miR-146a-5p had area under curve (AUC) of 0.813, sensitivity 66% & specificity 86%. miR-155-5p (mean ± SD); p value (CI) among APS group versus Control group = (0.57 ± 1.0) versus (0.48 ± 0.7); 0.60 (-0.25-0.43). miR-155-5p had (AUC) of 0.582, sensitivity 92% & specificity 40%. (mean ± SD); P value (CI) of IL-8 in APS group versus control group = (6.11 ± 1.2) versus (5.19 ± 0.5); CI(-0.36- 0.52), <i>p</i> < .001. <b>Conclusion:</b> miR-146a-5p significantly higher among APS group. IL-8 significantly more predominates among APS group. Alterations in miRNA expression are involved in thrombosis associated pregnancy complications.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"572-580"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, serological, and targeted genetic analysis of systemic lupus erythematosus in Kazakhstan.","authors":"Lina Zaripova, Abay Baigenzhin, Alyona Boltanova, Zhanna Zhabakova, Maxim Solomadin, Diana Makimova, Larissa Kozina","doi":"10.1177/09612033261430585","DOIUrl":"10.1177/09612033261430585","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by the production of various antibodies and immune complex-mediated injury. Limited information exists about Kazakh patients, a heterogeneous group with different clinical manifestations and potentially unique genetic basis.ObjectiveTo describe the clinical features, associated autoantibody and cytokine profile, and the frequency of rare variants in a limited panel of genes.MethodThis study enrolled 43 Kazakh individuals: 25 with SLE and 18 healthy controls. Disease activity was assessed using the SLEDAI-2K score. Laboratory tests included C3 and C4 complement components, interleukin (IL)-6, IL-5, IL-10, IL-18, IFN and antiphospholipid IgG/IgM identified by ELISA. The antinuclear factor (ANF) on HEp-2 cells was detected using indirect immunofluorescence. Specific autoantibodies were identified by immunoblotting. A custom AmpliSeq panel of 120 genes was used on the Ion Proton Sequencer.ResultsSLE patients (SLEDAI-2K = 11,48 ± 8,7) demonstrated skin lesions (88%), joint involvement (84%), lupus nephritis (56%), and hematological disorders (40% patients). Cardiac and vascular injury was each observed in 36% of patients, while involvement of nervous system, mucous membranes, and thyroid gland each occurred in 8% of cases. Immunological tests revealed positive ANF in the majority of patients (92%) with anti-dsDNA, nucleosomes, Smith, SS-A/Ro52, SS-A/Ro60, U1-snRNP, and Rib-P0 antibodies. IL-6, IL-18, IFN levels were markedly elevated in patients with SLE relative to controls (<i>p</i> = .02), reflecting enhanced systemic inflammatory activity. Elevated IL-10 was found as well in patients with SLE relative to controls (<i>p</i> = .02). According to the results of gene panel sequencing, the most significant variants were found in genes SAMD9L, REL, IRAK1, PTPRC, TLR7, TNFAIP3, IL6ST, BLK, CCR5, TFPI, CLEC16 A, IL2RB, ITGA2B, ABCC2, KIF5A, NCF2, and CD5, none of which showed statistically important enrichment in the disease cohort.ConclusionAnalysis of data obtained from Kazakh patients with SLE revealed diverse autoimmune profiles, including various antibodies, pro- and anti-inflammatory cytokines, as well as several variants in REL, IRAK1, PTRPC, IL6ST genes. The findings presented may contribute to the development of personalized diagnostic tools for predicting disease trajectories and guiding treatment decisions.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"611-622"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for ICU admissions and mortality in systemic lupus erythematosus in a South Indian tertiary centre - An observational study.","authors":"Amirtha Gopalan, Sarath Chandra Mouli Veeravalli, Keerthi Vardhan Yerram, Abitha Aliyar, Suvarna Shilpa, Prakash Paymode, Vivek Vardhan Yerram","doi":"10.1177/09612033261430567","DOIUrl":"10.1177/09612033261430567","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune disease; the course of illness is interspersed with disease flares, infections, adverse drug events which may at times warrant intensive care admission. Reasons for admission and mortality predictors in intensive care units (ICUs) differ globally. This study offers a regional perspective by examining these factors in an Indian context.MethodsThis is a single centre ambispective observational study from a tertiary care hospital in South India. Patients with SLE admitted to ICU due to any cause between 2015 and 2021 were included. The primary objective was to describe reasons for admission to ICU among patients with SLE and secondary objectives were to determine short term mortality rate and factors predicting mortality. Patients' baseline disease characteristics, reason for current hospitalization and final outcome of mortality or discharge from hospital were studied from medical records. Descriptive statistics were used and logistic regression was used to predict in-hospital mortality with different variables.ResultsEighty-seven patients were included in the study. The mean age was 33.16 ± 12.6 years and 87% were female. The most common causes for admission were high disease activity with infection (48%) and high disease activity alone (39%). Mean APACHE II and SLEDAI-2K scores at admission were 17.32 ± 6.42 and 15.16 ± 8.3, respectively. The mean duration of ICU stay was 6.02 ± 6.58 days. The overall mortality rate was 29% with infection and disease activity being major contributors. In the multivariate model excluding cardiac arrest, APACHE II score (OR 1.56, 95% CI: 1.14-2.17, <i>p</i> = 0.010), RRT (OR 7.41, 95% CI: 2.86-20.00, <i>p</i> < 0.001), and lactate (OR 1.06, 95% CI: 1.01-1.10, <i>p</i> = 0.009) emerged as independent predictors of mortality.ConclusionThe leading cause of admission to ICU in our cohort was high disease activity with or without concomitant infection. The mortality rate in our study population was 29%, which is in line with the observed trend in the last 2 decades. APACHE II score at presentation, need for RRT, and baseline serum lactate emerged as independent predictors of ICU mortality.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"639-647"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosis in patients with systematic lupus erythematosus: A systematic literature review and meta-analysis.","authors":"Konstantinos Parperis, Panagiotis Zis, Marina Evangelou, Avgoustina Kyriakou, Eleni Koliou, Heraklis Pantelidakis, Andreas Chatzittofis","doi":"10.1177/09612033261432704","DOIUrl":"10.1177/09612033261432704","url":null,"abstract":"<p><p>ObjectivesPsychosis is a rare but severe neuropsychiatric manifestation of systemic lupus erythematosus (SLE). Its prevalence, clinical predictors, and immunopathogenesis remain incompletely understood. This study aimed to estimate the prevalence of psychosis in adult SLE patients and identify associated clinical and immunological risk factors.MethodsThis systematic review and meta-analysis was conducted following PRISMA guidelines. A comprehensive search of PubMed, Embase, and the Cochrane Library was conducted to identify all relevant studies with ≥10 adults through November 2024. Case-series, case reports, narrative reviews and conference abstracts were excluded. Quality assessment employed the Cochrane Risk of Bias Tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies. Statistical analysis was performed using the random-effects model, with heterogeneity assessed via I² statistics.ResultsA total of 65 studies, comprising 31,495 SLE patients, were included. The pooled prevalence of psychosis in SLE patients was 4.5% (95% CI: 3.6%-5.5%) and 20.5% (95% CI: 10.0%-37.6%) among neuropsychiatric SLE (NPSLE) patients. Psychosis frequently occurred within 2 years of SLE onset and was strongly associated with higher SLE disease activity, positive anti-ribosomal P antibodies, antiphospholipid antibodies, and complement consumption. Delusions and hallucinations predominated among clinical presentations. Heterogeneity among studies was substantial.ConclusionObservational studies have reported that psychosis in SLE is strongly associated with increased disease activity and immune dysregulation. Anti-ribosomal P antibodies demonstrate a high negative predictive value, offering a valuable diagnostic adjunct. Recognition of psychosis may prompt closer clinical evaluation and, where appropriate, consideration of immunosuppressive treatment.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"592-610"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of CYP2C19 polymorphism with cyclophosphamide-induced toxicity in systemic lupus erythematosus and lupus nephritis: A systematic review and meta-analysis.","authors":"Azad Jha, Smriti Jha, Ganesh Chauhan","doi":"10.1177/09612033261429138","DOIUrl":"10.1177/09612033261429138","url":null,"abstract":"<p><p>BackgroundCyclophosphamide (CYC) is a key immunosuppressive agent used for the treatment of systemic lupus erythematosus (SLE) and lupus nephritis (LN). However, its use is often limited by variability in efficacy and toxicity, potentially influenced by genetic polymorphisms. This systematic review and meta-analysis aimed to evaluate the association between the CYP2C19 polymorphism and cyclophosphamide-induced toxicity in SLE and LN patients.MethodsLiterature search was performed using PubMed and Web of Science databases in accordance with PRISMA guidelines. Studies were included if they evaluated cyclophosphamide therapy in SLE or LN patients, assessed genetic polymorphisms, and reported toxicity outcomes. Meta-analysis was performed using inverse variance weighted fixed effect and random effect, publication bias was checked using funnel plot and risk of bias was assessed using ROBINS E tool.ResultsOut of 1,713 identified articles, a total of 5 studies were eligible for meta-analysis which studied CYP2C19*2 genetic Polymorphism and CYC induced toxicity. It showed a significant association with protective effect (OR = 0.28, 95% CI: 0.099-0.845, <i>p</i> = .021). Funnel plots suggested potential publication bias in CYP2C19*2 studies, while the risk of bias assessment revealed some concerns regarding confounding and outcome measurement.DiscussionThis meta-analysis supports the utility of CYP2C19*2 genotyping in predicting CYC induced toxicity in SLE and LN patients. Small sample sizes, confounding factors, and variability in outcome assessment were found to be the key limitations. Larger, multi ethnic studies with standardized toxicity assessments are recommended to validate these findings and explore these pharmacogenetic markers for optimizing CYC therapy.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"543-550"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}