Lupus最新文献

{"title":"Gaps in cervical cancer screening and HPV vaccination in women with systemic lupus erythematosus.","authors":"Mahnoor Javed, Deepak Jagannath, Alwyn Mathew, Konrad Harms, Myriam Guevara","doi":"10.1177/09612033261494026","DOIUrl":"https://doi.org/10.1177/09612033261494026","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261494026"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111518","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":"Diagnosis to dialogue: Reproductive health conversations and guideline adherence in women with lupus.","authors":"Akhil Sood, Leanna M Wise, Sadaf Sediqi, Amanda Moyer, Ellie Diamond, Alyssa Howren, Yashaar Chaichian, Julia F Simard","doi":"10.1177/09612033261465938","DOIUrl":"10.1177/09612033261465938","url":null,"abstract":"<p><p>ObjectiveTo examine patient-reported adherence to the American College of Rheumatology (ACR) reproductive health guidelines among females of childbearing age with systemic lupus erythematosus (SLE) seen at a tertiary care center.MethodsFemales with SLE aged 18-50 years who were evaluated by a rheumatologist at a tertiary care center from January 2022 to March 2024 were invited to complete an online survey. The survey assessed whether reproductive health topics had been discussed with their rheumatologists, including: contraception, pregnancy planning (i.e., medication compatibility and disease remission), and hydroxychloroquine (HCQ) use during preconception and pregnancy. Descriptive statistics were used to summarize the characteristics of all participants and reproductive health outcomes. Exploratory bivariate analyses identified factors associated with use of effective or highly effective contraception (EHEC), contraceptive counseling, and screening for pregnancy plans among females of reproductive potential.ResultsThe cross-sectional study included 102 participants (mean age 35 years). Most participants identified as White (36.3%) or Asian/Pacific Islander (32.4%). Among participants with pregnancy history after SLE diagnosis (n = 34), most reported having pregnancy planning discussions, including HCQ use, with their rheumatologist. However, fewer than one-third of all participants reported receiving contraceptive counseling by their rheumatologist in the past year. In exploratory analyses, contraceptive counseling varied significantly by race, employment status, disease duration, and who was most likely to initiate reproductive health conversations. EHEC use varied significantly by race, with numerically higher use among White participants (59.4%).ConclusionOur findings highlight specific gaps in reproductive healthcare among females with SLE, alongside areas of high adherence with guidelines. Notable differences in contraceptive use and counseling underscore important opportunities to deliver quality care in this high-risk patient population.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1142-1151"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405180","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 GPX4 rs713041 and rs4807542 polymorphisms and serum GPX4 levels in Chinese patients with systemic lupus erythematosus.","authors":"Xu Li, Lin Su, Xiang Li, Caifang Qin, Zhuo Qin, Yanan Sun, Xing Wei, Shuo Yang, Yongchao Liu, Ning Liu, Zhihong Zhang, Jiping Wu","doi":"10.1177/09612033261465940","DOIUrl":"10.1177/09612033261465940","url":null,"abstract":"<p><p><b>Objectives:</b> To investigate the association of serum glutathione peroxidase 4 (GPX4) levels and GPX4 polymorphisms with systemic lupus erythematosus (SLE) and lupus nephritis (LN) in a Chinese population.<b>Methods:</b> This hospital-based case-control study included 28 patients with LN, 28 patients with SLE without renal involvement, and 28 healthy controls for measurement of serum GPX4 levels using enzyme-linked immunosorbent assay (ELISA). In addition, 104 patients with SLE (including 64 with LN and 40 without renal involvement) and 100 healthy controls underwent genotyping of target single-nucleotide polymorphisms (SNPs) by polymerase chain reaction-coupled Sanger sequencing. Multivariable binary logistic regression analyses were performed to adjust for potential confounding factors.<b>Results:</b> Serum GPX4 levels were significantly lower in both the LN and non-LN groups than in the healthy control group, and GPX4 showed moderate diagnostic accuracy for SLE detection. In univariate analyses, carriers of the CC genotype and C allele at rs713041, as well as carriers of the GA genotype and A allele at rs4807542, had a significantly increased risk of SLE compared with healthy controls. Multivariable binary logistic regression further showed that the rs713041 CC genotype and rs4807542 A-carrier status remained independently associated with SLE susceptibility after adjustment for age and sex. Furthermore, in comparisons between LN and non-LN patients, carriers of the CC genotype and C allele at rs713041 were significantly associated with an increased risk of LN in univariate analyses, and the rs713041 CC genotype remained independently associated with renal involvement after adjustment for age, sex, disease duration, and SLEDAI score.<b>Conclusions:</b> Reduced serum GPX4 levels in both LN and non-LN patients suggest that GPX4 may be involved in the pathogenesis of SLE-related renal injury. In addition, GPX4 polymorphisms rs713041 and rs4807542 were independently associated with SLE susceptibility, whereas only rs713041 was independently associated with renal involvement in patients with SLE. These findings suggest that rs713041 may serve as a potential genetic marker of LN susceptibility in the Chinese population.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1152-1165"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376299","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":"Association of serum and urinary galectin-3 with renal fibrosis in patients with lupus nephritis: A cross-sectional controlled study.","authors":"Ahmed Mohamed Fahmy, Rasha Youssef Hagag, Amira Mahmoud Radwan, Asmaa Mounir Emara, Ahmed Abdelazim Elmoghany","doi":"10.1177/09612033261465933","DOIUrl":"10.1177/09612033261465933","url":null,"abstract":"<p><p>ObjectiveOur objective was to explore the correlation between serum (sGal-3) and urinary galectin-3 (uGal-3) levels and renal fibrosis (RF) severity in lupus nephritis (LN) patients, besides assessing their diagnostic performance for identifying moderate/severe interstitial fibrosis and tubular atrophy (IFTA).MethodsThis cross-sectional controlled study recruited 150 participants: 50 LN patients, 50 diagnosed with systemic lupus erythematosus (SLE) without LN, and 50 healthy controls. Both sGal-3 and uGal-3 levels were measured using ELISA. Histopathological assessment included evaluation of IFTA severity. Patients with LN were stratified into mild IFTA (<26%) and moderate/severe IFTA (≥26%). Moreover, we performed correlation, ROC curve, and multivariable logistic regression analyses.ResultsLN patients showed significantly higher sGal-3 and uGal-3 levels than other groups (<i>p</i> < 0.001). Both biomarkers exhibited strong positive correlations with IFTA percentage (sGal-3: rho = 0.76; uGal-3: rho = 0.81; <i>p</i> < 0.001). Unlike those with mild IFTA, moderate/severe IFTA patients had significantly higher sGal-3 and uGal-3 levels (<i>p</i> < 0.001). Based on ROC analysis, uGal-3 had higher discriminatory ability for moderate/severe IFTA (AUC = 0.903) than sGal-3 (AUC = 0.801). In multivariable logistic regression, both sGal-3 and uGal-3 levels were independently associated with moderate/severe IFTA after adjusting for renal function parameters.ConclusionsBoth sGal-3 and uGal-3 levels are significantly associated with RF severity in LN. The uGal-3 had superior diagnostic performance for moderate/severe IFTA and may be a promising non-invasive RF biomarker in LN. Validation in large-scale prospective studies is warranted.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1134-1141"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345876","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":"Autonomic dysfunction in systemic lupus erythematosus and systemic sclerosis.","authors":"Aysegul Avcu, Zeynep Hazal Baltaci, Dilara Deniz Ergin, Ebru Asicioglu, Haner Direskeneli, Fatma Alibaz-Oner","doi":"10.1177/09612033261466750","DOIUrl":"10.1177/09612033261466750","url":null,"abstract":"<p><p>Background and ObjectiveAutonomic dysfunction may arise in chronic systemic diseases, including autoimmune connective tissue disorders. This study aimed to quantify autonomic symptom burden in patients with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc), examine clinical correlates, and compare results with controls without autoimmune disease.MethodsThis cross-sectional study included 50 SLE patients, 50 SSc patients, and 35 controls. Clinical and demographic characteristics were collected during visits. Autonomic symptom burden was assessed using the Composite Autonomic Symptom Score-31 (COMPASS-31). COMPASS-31 total and subdomain scores were examined across groups and within disease groups according to clinical and serological variables. A post-hoc COMPASS-31 score >32.5 was used to define high autonomic symptom burden.ResultsMedian total COMPASS-31 scores differed across groups and were higher in both SLE and SSc than in controls (15.43 and 20.53 vs 9.03; <i>p</i> = 0.001). Compared with SLE, SSc had higher orthostatic and vasomotor symptom burden. Using COMPASS-31 > 32.5, high autonomic symptom burden was present in 7/50 (14%) SLE and 13/50 (26%) SSc patients, while none of the controls exceeded the cut-off. In multivariable models, serositis and joint involvement predicted high symptom burden in SLE, whereas clinically significant gastrointestinal involvement and musculoskeletal involvement were independent predictors in SSc. After adjustment for age, sex, and comorbidity, total COMPASS-31 remained higher than in controls in both SLE (β = 7.01; <i>p</i> = 0.013) and SSc (β = 11.24; <i>p</i> < 0.001).ConclusionAutonomic symptom burden appears to be higher in patients with SLE and SSc than in controls. The subgroup differences suggest that autonomic symptoms may cluster with specific organ involvement. COMPASS-31 may be a practical screening tool to identify patients who could benefit from further objective autonomic evaluation. Routine, structured assessment may support timely recognition and management of autonomic symptoms in clinical practice.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1166-1174"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368850","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":"Anifrolumab induces a fast improvement in ultrasound-detected synovitis in systemic lupus erythematosus: Results from a 6-months follow-up ultrasound study.","authors":"Fulvia Ceccarelli, Claudia Ciancarella, Valeria Moretti, Domenico Iaria, Francesca Romana Spinelli, Cristiano Alessandri, Fabrizio Conti","doi":"10.1177/09612033261469032","DOIUrl":"10.1177/09612033261469032","url":null,"abstract":"<p><p>ObjectiveAnifrolumab (ANF) has been approved to treat extra-renal manifestations in Systemic Lupus Erythematosus (SLE) patients. Real-life data underline the excellent efficacy in skin involvement, but very little is known on other manifestations. We conducted a prospective longitudinal analysis to assess ANF efficacy in SLE-related joint involvement by using ultrasound.MethodsWe enrolled patients receiving ANF for musculoskeletal manifestations. All the patients were evaluated at baseline (T0) and after 1 (T1) 3 (T3) and 6 (T6) months of treatment.US assessment was performed at level of bilateral hands MCP and PIP joints. According to the OMERACT, we evaluated the presence of US inflammatory features (synovial effusion/hypertrophy, Power Doppler - pD), measured by semiquantitative score (0-3), resulting in a total US inflammatory score (0-180) and total PD score (0-60).ResultsOur cohort comprised 13 female patients. During the follow-up period, we found a significant reduction of US scores already after 1 month of treatment, with a further significant reduction after 3 and 6 months. Interestingly, after 6 months, 90% of patients showed negativization of pD signal in all the joints. Parallelly, we found a significant improvement in global disease activity indices and in DAS28crp values at all the time-points.ConclusionsOur analysis, made in a real-life scenario, underlines the fast efficacy of ANF on joint synovitis as shown by the reduction in US scores in the early stages of treatment. The rapid effect on pD signal suggest the ability of this drug to prevent the development of erosive damage.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1198-1202"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412267","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":"Continuation of belimumab in patients with systemic lupus erythematosus in a real-world setting: A single-center retrospective cohort study.","authors":"Natsuko Hara, Yuko Okamoto, Yasuhiro Katsumata","doi":"10.1177/09612033261465928","DOIUrl":"10.1177/09612033261465928","url":null,"abstract":"<p><p>ObjectiveThis study aimed to investigate belimumab continuation and identify clinical parameters predicting belimumab continuation in patients with systemic lupus erythematosus (SLE) in a real-world setting.MethodsA total of 38 consecutive patients with SLE who were newly treated with belimumab at our institution from 2018 to 2024 were retrospectively analyzed. The data were censored when belimumab was discontinued or the observation period ended. Clinical and laboratory data were retrospectively collected.ResultsThe median follow-up time after starting belimumab was 37 months (IQR 12-52). The 1-year belimumab continuation rate was 29/38 (76%). During the entire observation period, 15 (39%) patients discontinued belimumab. Among the 10 patients who discontinued belimumab due to lack of efficacy, seven were switched to other biologics. The overall discontinuation rate was 13.4 per 100 person-years. Absence of serological activity (increased anti-dsDNA and/or hypocomplementemia) at baseline was a significant risk factor for belimumab discontinuation within 1 year (<i>p</i> = 0.034), with a relative risk of 3.43 (95% CI, 1.01-11.6). The glucocorticoid dosage was significantly reduced in the 29 patients treated with belimumab for ≥12 months (<i>p</i> < 0.001). Among the 33 patients who were not in the low disease activity state (LLDAS) at baseline, 19 (58%) were in the LLDAS at their final visit (<i>p</i> < 0.001). Belimumab was temporarily discontinued in six patients due to infection, but all patients resumed it.ConclusionThe belimumab continuation rate was high among patients with SLE in real-world settings; however, the absence of serological activity at belimumab initiation was a significant risk factor for discontinuation within 1 year.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1192-1197"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148330657","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":"Hematological involvement in juvenile-onset systemic lupus erythematosus: Clinical features and its impact on disease management.","authors":"Emine Özçelik, Elif Çelikel, Zahide Ekici Tekin, Şeyma Ertem, Merve Cansu Polat, Şeyma Erdem Torun, Didem Öztürk, Mehveş Işıklar Ekici, Yasemin Uğur Es, Sultan Nilay Yoğun, Cüneyt Karagöl, Özlem Arman Bilir, Neşe Yaralı, Namık Yaşar Özbek, Banu Çelikel Acar","doi":"10.1177/09612033261477290","DOIUrl":"10.1177/09612033261477290","url":null,"abstract":"<p><p>ObjectiveHematological involvement is a common manifestation of juvenile-onset systemic lupus erythematosus (jSLE). While nephrological and neurological involvement often guide treatment decisions in the early disease course, hematological findings may also impact morbidity and mortality. The aim of this study is to evaluate the clinical characteristics and treatment approaches of jSLE patients with hematological involvement.MethodThis retrospective, single-center cohort study was conducted on patients diagnosed with jSLE who were followed up at the pediatric rheumatology clinic between January 2015 and May 2025. Patients included in the study had been diagnosed with jSLE according to the 2012 Systemic Lupus International Collaborating Clinics classification criteria.ResultsThe study included 53 SLE patients, 48 of whom (90.6%) were female. The median age at diagnosis was 13 years (IQR: 11-15), and the median follow-up period was 26 months (IQR: 12-48). Hematological involvement was detected in 28 patients (52.8%). Anemia was observed in 18 (64.3%) of 28 patients, followed by lymphopenia in 16 (57.1%), thrombocytopenia in 14 (50.0%), and pancytopenia in 4 (14.3%). The median time to improvement of cytopenia following treatment was 32 days (IQR: 27-61). In 11 patients, treatment was based on isolated hematological findings, whereas in 17 patients with additional major organ involvement, treatment was mainly directed by the major organ manifestations. The frequency of constitutional symptoms, hypocomplementemia, and direct Coombs positivity were found to be significantly higher in patients with hematological involvement (<i>p</i> = 0.003, <i>p</i> = 0.034, <i>p</i> = 0.039, respectively). Intravenous ımmunoglobulin (IVIG) was also found to be administered more frequently in patients with hematological involvement (<i>p</i> = 0.010).ConclusionHematological involvement was detected in approximately half of jSLE patients. Hypocomplementemia and positive Coombs test were more frequently observed in patients with hematological involvement. The use of IVIG was also more common in patients with hematological involvement, and individualized treatment options remain important in the management of the disease.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1301-1307"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725102","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":"Network meta-analysis of triple immunosuppressive therapies and standard of care for induction of remission of active lupus nephritis.","authors":"Gabriel Contreras, Vinodh Mechery, Sanjana Kota, Daniel Del Castillo Rix, Miguel Bandes, Adriana Dejman, Yiqin Zuo, Juan Camilo Duque, Jair Munoz Mendoza","doi":"10.1177/09612033261474940","DOIUrl":"10.1177/09612033261474940","url":null,"abstract":"<p><p>BackgroundIn patients with active lupus nephritis (LN), 8 different triple immunosuppressive therapies have been compared to the standard of care (SOC) of double immunosuppressive therapy in 12 induction randomized clinical trials (RCTs). The triple immunosuppressive therapies of SOC+Tacrolimus, SOC+Voclosporin, SOC+Belimumab, and SOC+Obinutuzumab compared to SOC alone demonstrated significantly higher remission of LN without excessive risk of serious adverse events (SAEs) and serious infectious events (SIEs) in RCTs. Direct or indirect comparisons among triple immunosuppressive therapies have not been studied. In this network meta-analysis (NMA), we systematically provide indirect comparisons of the relative efficacy and safety of triple immunosuppressive therapies, ranking them according to efficacy achieving primary renal remission (PRR) of LN and safety reducing the risk of SAEs and SIEs.ResultsThe NMA included predominantly women with LN. In direct pairwise comparisons, SOC+Tacrolimus (benefit ratio 1.91 [95% Credible Interval 1.45 to 2.56]), SOC+Voclosporin (1.69 [1.30 to 2.23]), SOC+Obinutuzumab (1.41 [1.09 to 1.84]), and SOC+Belimumab (1.32 [1.04 to 1.69]) had significantly higher PRR compared to SOC alone. In indirect pairwise comparisons, patients who received SOC+Tacrolimus compared to SOC+Rituximab (2.30 [1.27 to 4.20]), SOC+Anifrolumab (1.98 [1.07 to 3.52]), SOC+Ocrelizumab (1.81 [1.12 to 2.82]), and SOC+Abatacept (1.78 [1.07 to 2.91]) had significantly higher PRR. Patients who received SOC+Voclosporin compared to SOC+Rituximab (2.03 [1.14 to 2.68]) had significantly higher PRR. SOC+Belimumab, SOC+Obinutuzumab, SOC+Voclosporin and SOC+Tacrolimus ranked as effective therapies inducing PRR with SUCRA probability scores between 61.14% and 95.12%. Risk ratios of SAE and SIE were not significantly different among the immunosuppressive therapies.ConclusionIn patients with LN, induction therapies of SOC with calcineurin inhibitors had the highest relative benefit achieving remission of LN.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1257-1268"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679180","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":"Stigma, discrimination-related events, and determinants among adult people living with systemic lupus erythematosus (SLE): Systematic review and indicator-level meta-analysis.","authors":"Hebatullah M Abdulazeem, Syrine Bellakhal, Rym Abida, Saeed Soliman","doi":"10.1177/09612033261474062","DOIUrl":"10.1177/09612033261474062","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) is a complex autoimmune disease with 0.4 million new cases diagnosed annually. With its wide variety of visible and invisible manifestations, people living with SLE report being exposed to stigmatization, which impacts their personal and professional lives. However, the current literature is unclear on whether healthcare management teams assess this concern during follow-up. This study aims to synthesize existing evidence on the prevalence and determinants of stigma among people living with SLE.MethodsThis systematic review and meta-analysis gathered evidence from observational studies identified from three databases on 16 July 2025. Dual independent screening, data extraction, and risk-of-bias assessment (using the Newcastle-Ottawa Scale) were performed. Results were synthesized using descriptive statistics, narrative synthesis, and indicator-level meta-analyses.ResultsWithin the past two decades, 11 studies comprising 2254 people living with SLE reported and measured stigma- and discrimination-related events using various scales. Stigma was found to be prevalent across its three constructs: interpersonal, perceived, and intrapersonal stigma. This review demonstrated that people living with SLE reported a moderate overall burden of stigma (34.71 [95% CI 26.15, 43.27]), with average stigma scores indicating psychological impact. Additionally, nearly one in two persons (46% [95% CI 28-66%]) experienced at least one form of stigma or discrimination, most commonly social isolation and unfair treatment. Mental health associations were correlated with higher stigma burden.ConclusionThis review demonstrates that stigma and discrimination are not just social challenges but also critical determinants of health. With cautious interpretation, pooled evidence reveals a consistent high prevalence of stigma and discrimination, which act as \"toxic\" stressors, creating a vicious cycle with psychological stress and psychiatric manifestations and disease activity. There is an urgent clinical need to move beyond a mere biological approach to disease assessment and management and to begin screening for the \"invisible\" burden of invalidation and discrimination.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1269-1281"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689566","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}