Lupus最新文献

{"title":"Association between antiphospholipid syndrome and postural orthostatic tachycardia syndrome (POTS).","authors":"Aashish Batheja, Nehal R Shah","doi":"10.1177/09612033251353082","DOIUrl":"10.1177/09612033251353082","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"984-986"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317327","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":"Epigenetic mechanisms of B cells: Recent advances in targeted therapies for SLE.","authors":"Kunyu Cao, Xiaoping Du, Miao Tu, Yujiao Wei, Liu Wan, Jiyu Ju","doi":"10.1177/09612033251348154","DOIUrl":"10.1177/09612033251348154","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a complex autoimmune disease, and abnormal B-cell function plays a key role in its pathogenesis. Multiple epigenetic mechanisms, such as DNA methylation, histone modification, and non-coding RNAs, can regulate B cell development, differentiation, and function. This review outlines the relationship between the epigenetic regulation of B cells and the pathogenesis of SLE and prospectively discusses possible therapeutic approaches.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"879-887"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225852","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":"A study of calcineurin inhibitors in comparison with intravenous cyclophosphamide for initial induction treatment of lupus nephritis class Ⅲ, Ⅳ, V in Chinese children.","authors":"Yanxinli Han, Hongyu Sha, Lanqi Zhou, Yuan Yang, Yi Wang, Zhuowei Yu, Liru Qiu, Yu Zhang, Jianhua Zhou","doi":"10.1177/09612033251351338","DOIUrl":"10.1177/09612033251351338","url":null,"abstract":"<p><p>BackgroundLupus nephritis (LN) is one of the most common secondary glomerulonephritis in children, and may progress to end-stage kidney disease if remission induction is not successful. Currently, the recommended induction treatment for lupus nephritis class Ⅲ/Ⅳ/V are corticosteroids combined with cyclophosphamide (CYC). Although tacrolimus has demonstrated comparable efficacy to CYC in adult patients with LN, its effectiveness and safety in the treatment of childhood lupus nephritis (cLN) have not been extensively investigated, particularly in comparison to cyclophosphamide (CYC). The objective of this study is to retrospectively assess the effect of calcineurin inhibitors (CNIs) compared to CYC as the initial induction therapy for class Ⅲ/Ⅳ/Ⅴ cLN.MethodscLN of class Ⅲ/Ⅳ/V treated initially with intravenous CYC or CNIs from January 2009 to January 2022 were included. The collected clinical, pathological, and treatment data were analyzed to assess and compare the efficacy and safety of CNIs versus CYC.ResultsA total of 75 LN patients were eligible. 46 patients received corticosteroids combined with intravenous CYC for induction remission, while 29 patients with oral CNIs, mainly tacrolimus. The CNI group had a significantly higher complete remission (CR) rate (55.2%) compared to the CYC group (17.4%) after 3 months of treatment, and this difference remained at 6 months (62.1% vs 26.1%). The reduction of proteinuria was also more significant in the CNI group compared to the CYC group at 3-month induction. The overall incidence of adverse effects was significantly lower in CNI than in CYC (17% vs 63%, <i>p</i> = 0.032). Multiple logistic regression analysis identified edema, anti-dsDNA, and CYC as risk factors for non-remission after 6-month induction therapy.ConclusionsThis study demonstrates that CNIs are safer and more effective than CYC for quickly reducing proteinuria and achieving higher CR rate in initial induction treatment for lupus nephritis class III/IV/V.Clinical Trial RegistrationChiCTR2300075587.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"961-971"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326183","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 truncal involvement in lupus erythematosus panniculitis patients with calcinosis cutis: A retrospective cohort study.","authors":"Jay Garza, Benjamin F Chong","doi":"10.1177/09612033251349451","DOIUrl":"10.1177/09612033251349451","url":null,"abstract":"<p><p>BackgroundLupus erythematosus panniculitis (LEP) is a rare variant of cutaneous lupus erythematosus that typically presents as indurated nodules or plaques. Calcinosis cutis (CC) is a potential complication of this disease with limited treatment modalities and significant quality of life complications. The rate and risk factors of CC in LEP are not well understood. Thus, we conducted a retrospective cohort study on patients diagnosed with LEP.ObjectiveTo quantify the rate of CC and to identify the risk factors associated with its development in LEP.MethodsThis retrospective cohort study analyzed data from 27 LEP patients recruited in outpatient dermatology clinics at University of Texas Southwestern Medical Center and Parkland Health from January 2009 to December 2024. The primary outcome measure was CC development based on clinical diagnosis from a dermatologist, biopsy, or radiographic imaging. Data collected included demographics, smoking history, disease duration, medications, and lesion location. Predictor variables associated with CC development were analyzed either by Mann-Whitney U or Fisher's exact tests.Results10/27 (37%) LEP patients had CC during the evaluation period. LEP patients with CC had a higher rate of truncal involvement (9/10 (90%) versus 7/17 (41.2%); <i>p</i> = .02) and a lower rate of head & neck involvement (3/10 (30%) versus 13/17 (76.5%); <i>p</i> = .04) of their LEP lesions compared to those without CC.LimitationsThis study is limited by its single-center design, retrospective nature, and small sample size.ConclusionsThis cohort of LEP patients had over a third developing CC. LEP lesion location significantly differed in those who developed CC compared with those who did not. CC is a common complication of LEP that requires close monitoring by clinicians. Prospective multicenter studies are needed to confirm these findings and better understand the predictive factors for the development of CC in LEP patients.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"972-977"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248539","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":"Diagnostic overshadowing in systemic lupus erythematosus (SLE): A qualitative study.","authors":"Rupert Harwood, Chris Wincup, David D'Cruz, Melanie Sloan","doi":"10.1177/09612033251345184","DOIUrl":"10.1177/09612033251345184","url":null,"abstract":"<p><p>ObjectivesSLE diagnostic journeys can be protracted, with negative impacts on long-term health. This study explored the role of diagnostic overshadowing (DOS) in delaying SLE diagnoses.MethodsA qualitative analysis of 268 completed SLE patient surveys and 25 in-depth interviews purposively selected from the 2018-2021 Cambridge University Systemic Autoimmune Rheumatic Disease (SARD) studies.ResultsThe majority of participants appear to have experienced DOS and there were indications that sustained DOS (S-DOS) may add years to some SLE diagnostic journeys. Symptom misattributions which contributed to S-DOS included: (1) \"<i>Medical mystery</i>\", particularly when the clinician indicated that it was too expensive to keep investigating. (2) <i>Negative misattributions</i> (e.g. \"nothing seriously wrong\"), often due to a failure to connect multiple symptoms as possible indicators of an underlying condition. (3<i>) Diagnostic roadblocks,</i> including, in the case of some participants, a mental health, psychosomatic, ME/CFS or fibromyalgia (mis)diagnosis. (4) <i>Moral misattributions,</i> such as to \"malingering\", which could undermine patient help-seeking and/or clinician help-giving.ConclusionOur data suggests that DOS may be an important factor in diagnostic delay in patients with SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"819-831"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258385","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":"Maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus: A study from a Latin American developing country.","authors":"Juan Esteban Bedoya-Loaiza, Catalina Sanmiguel-Reyes, Claudia Ibáñez-Antequera, Alejandro Escobar, Adriana Rojas-Villarraga, Jairo Cajamarca-Barón","doi":"10.1177/09612033251345648","DOIUrl":"10.1177/09612033251345648","url":null,"abstract":"<p><p>IntroductionSystemic lupus erythematosus (SLE) primarily affects women of reproductive age. In pregnant women, frequent antepartum and intrapartum monitoring is required to improve obstetric outcomes and reduce the risk of flares. This study describes the characteristics of pregnant women with SLE and their obstetric and disease outcomes.MethodsRetrospective descriptive cohort in a hospital in Bogotá, Colombia, from 1/January/2012 to 29/February/2024. The research was approved by the Ethics Committee. Descriptive statistics and univariate analysis by Fisher and Mann-Whitney U test were used.ResultsWe analyzed 29 pregnancies of 28 women with a median age of 28 years, high educational and socioeconomic level, belonging to the social security system, and residing in Bogotá. Most of them had been diagnosed with SLE before pregnancy (median disease duration of 60 months). Twenty percent had poly-autoimmunity. Overall disease activity was mild to moderate. Obstetric outcomes (e.g. preterm delivery) were associated with a moderate to severe SLEPDAI (Systemic Lupus Erythematosus Pregnancy Disease Activity Index) score in the second and third trimester (83%, <i>p</i> = .04), shorter disease duration (24 vs 96 months, <i>p</i> = .027) and proteinuria >1 g (40.91%, <i>p</i> = .03).ConclusionsThis study associates preterm delivery with factors such as proteinuria >1 g, shorter disease duration, and a moderate to severe score in the second trimester of pregnancy. A higher level of evidence is required to establish these associations with the causality of adverse outcomes in the Latin American population.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"864-873"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182998","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":"Cardiac magnetic resonance feature tracking evaluates left atrial strain in patients with systemic lupus erythematosus and mitral regurgitation.","authors":"Weiwei Huang, Jianhua Dong, Song Luo, Jun Zhang, Lingyan Zhang, Yan Ma, Bin Wang, Jingxin Wang, Weiqiang Dou, Li Qi, Weixin Hu, Longjiang Zhang","doi":"10.1177/09612033251344983","DOIUrl":"10.1177/09612033251344983","url":null,"abstract":"<p><p>PurposeTo explore left atrial (LA) function in patients with systemic lupus erythematosus (SLE) and mitral regurgitation assessed by cardiac magnetic resonance imaging feature tracking (MRI-FT).MethodIn this study, 64 SLE patients (35.0 ± 12.3 years, 49 females) and 50 age- and gender-matched healthy controls (32.1 ± 11.2 years, 32 females) were analyzed. Patients with SLE were further classified into two subgroups according to mitral regurgitation defined by echocardiography: mitral regurgitation subgroup (<i>n</i> = 32) and non-mitral regurgitation subgroup (<i>n</i> = 32). All subjects underwent cardiac magnetic resonance (CMR) examination and SLE patients underwent extra laboratory testing. LA volume and strain parameters were compared among the three groups, and a correlation analysis was further performed between CMR parameters and clinical variables.ResultsPatients in both mitral regurgitation and non-mitral regurgitation subgroups showed higher LAVmin (29.15 ± 7.5, 26.22 ± 8.23 vs 21.68 ± 7.67, <i>p</i> = .003, .026) and LAVimin (17.44,14.9 vs 12.62, <i>p</i> = .002,.046) than healthy control subjects. Abnormal LA reservoir, conduit and bump strain were also observed in SLE patients (all <i>p</i> < .05), with more severe reservoir (<i>p</i> = .006, .031) and bump strain (<i>p</i> = .01, .033) abnormality found in mitral regurgitation subgroup. In the SLE group, LA reservoir, bump and conduit strain were significantly positively correlated with LVEF (B = 0.467, <i>p</i> < .001 vs B = 0.019, <i>p</i> = .01 vs B = 0.168, <i>p</i> = .001 vs B = 0.036, <i>p</i> < .001 vs B = 0.020, <i>p</i> = .024). Conduit strain (εe, SRe) was positively correlated with LAEF (B = 0.229, <i>p</i> = .032 vs B = 0.027, <i>p</i> = .008).ConclusionMRI-FT based LA parameters may be considered a helpful tool to evaluate LA function in SLE patients, and LA strain may indicate severity of the cardiac dysfunction in SLE patients.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"799-809"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102163","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 characteristics and efficacy of intrathecal therapy in pediatric lupus encephalopathy.","authors":"Ruoyu Li, Lizhi Chen, Liping Rong, Mengjie Jiang, Yuxin Pei, Ying Mo, Xiaoyun Jiang, Yuanyuan Xu","doi":"10.1177/09612033251344192","DOIUrl":"10.1177/09612033251344192","url":null,"abstract":"<p><p>BackgroundTo summarize the clinical characteristics of pediatric lupus encephalopathy and to investigate the therapeutic efficacy of intrathecal methotrexate and dexamethasone in the treatment of pediatric lupus encephalopathy.MethodsA retrospective study was conducted on 83 children diagnosed with Neuropsychiatric systemic lupus erythematosus (NPSLE) at the Department of Pediatric Nephrology and Rheumatology of the First Affiliated Hospital of Sun Yat-sen University from January 2002 to December 2023. The intrathecal injection and non-injection groups were divided based on whether they received intrathecal injections of methotrexate and dexamethasone. Clinical symptoms, laboratory tests, renal biopsy pathology, disease activity, and treatments were compared between the two groups, and the efficacy of intrathecal injection therapy for NPSLE was also assessed.ResultsOf the 83 children with NPSLE, 14 were male and 69 were female. NPSLE was the initial manifestation in 12 (14.46%) patients, while 71 (85.54%) developed it after systemic lupus erythematosus onset. The most frequently observed symptoms were headache and seizures. Imaging (CT/MRI) in 81 children showed abnormalities in 64 (79.01%), with cerebral atrophy being most common. The results of electroencephalography in 21 patients demonstrated abnormalities in 14 cases, and 7 of the 29 patients exhibited abnormal cerebrospinal fluid findings. A total of 68.67% of NPSLE patients were classified as chronic kidney disease (CKD) stage 1, while 31.33% were CKD stage 2 or higher. Renal biopsy in 60 children commonly indicated class IV or IV+V. The SLEDAI score at initial consultation was 20.93 ± 6.41. Among the 83 patients, 10 (12.05%) received intrathecal injections with an average of 5.2 per patient. Before treatment, the injection group had higher SLEDAI scores (<i>p</i> < 0.05). After treatment, the resolution times for NPSLE-related symptoms and imaging were shorter in the injection group, although the difference did not reach statistical significance. Notably, the injection group had a lower SLEDAI score and a more pronounced reduction (<i>p</i> < 0.05).ConclusionChildren with NPSLE in our center demonstrated more severe disease and higher disease activity index. Methotrexate and dexamethasone intrathecal therapy provided faster symptomatic relief and reduced disease activity in children with NPSLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"844-851"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120217","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":"Physician perceptions of challenges and barriers to optimal care of systemic lupus erythematosus in Africa.","authors":"Farhanah Paruk, Dzifa Dey, Anisa Mosam, Oluwaytoyin Christina Amira, Mohammed Tikly","doi":"10.1177/09612033251344059","DOIUrl":"10.1177/09612033251344059","url":null,"abstract":"<p><p>IntroductionPrevious studies indicate that the prognosis of systemic lupus erythematosus (SLE) is poor in Africa. We surveyed African physicians for their perceptions of factors that impact negatively on optimal SLE care and interventions to improve care in Africa.MethodsA cross-sectional, online survey of African dermatologists, rheumatologists, nephrologists, and internists was conducted.ResultsResponses from 226 respondents mostly from West Africa and East Africa, majority practicing in university and state-funded hospitals showed that the commonest reasons for late diagnosis of SLE in Africa were lack of awareness of the disease amongst primary care doctors (92.4%), financial constraints (80.3%) and lack of access to health care (62.5%). Consulting traditional healers, the belief of bewitchment, lack of availability of diagnostic tests and concomitant chronic infections, (tuberculosis and HIV) were also perceived to have resulted in diagnostic delays, especially amongst East and West African respondents. The overwhelming majority (>90%) of respondents felt that increased health care and financial resources was the top priority to improving SLE care in Africa. Continuing medical education for generalists, training of specialists and patient education and awareness programs were considered less important interventions to improve SLE care.ConclusionThe study reveals that the primary reasons for late diagnosis of SLE in Africa are lack of awareness among primary healthcare doctors and financial constraints. Thus, the need for greater financial resources, especially for appropriate medications, medical education and improving patient understanding of the disease through support groups, to improve SLE care and outcomes in Africa.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"858-863"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174339","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":"Hypertension, proteinuria, and RAAS inhibition use in children with systemic lupus erythematosus: Data from a multi-institutional pediatric learning health system.","authors":"Joyce C Chang, Meredith A Atkinson, Amy Goodwin Davies, Mitchell Maltenfort, Ingrid Y Luna, Hanieh Razzaghi, Vikas R Dharnidharka, Joseph T Flynn, William E Smoyer, Mark M Mitsnefes, Bradley P Dixon, Caroline A Gluck, Rebecca Scobell, L Charles Bailey, Susan L Furth, Christopher B Forrest, Michelle R Denburg, Scott E Wenderfer","doi":"10.1177/09612033251345201","DOIUrl":"10.1177/09612033251345201","url":null,"abstract":"<p><p>ObjectivesTo assess the potential of a multi-institutional pediatric learning health system for comparative effectiveness research in pediatric-onset systemic lupus erythematosus (SLE), we characterized renin angiotensin aldosterone system (RAAS) inhibitor utilization and the feasibility of ascertaining key treatment indications and outcomes, including hypertension and proteinuria.MethodsWe identified children with SLE and lupus nephritis (LN) at 6 PEDSnet institutions using previously developed computable phenotypes. A reference population of controls without SLE was randomly sampled from the same rheumatology/nephrology clinics (<i>N</i> = 200 controls per site). We evaluated data completeness, plausibility, and conformance related to RAAS inhibitor treatment indications and outcomes: (a) percent of encounters with blood pressure (BP) readings, (b) percent of BP readings with paired height, (c) percent of patients with ≥1 urinalysis within 7 days of SLE diagnosis, (d) urinalyses for which proteinuria could be classified as normal or abnormal, and (e) RAAS inhibitor use.ResultsThere were 1303 patients with SLE, including 457 with LN. BP measurements were available at 62% of encounters, of which 96% were paired with a height within 90 days. BP distributions were higher in patients with SLE and LN compared to controls without SLE. One third of SLE patients had a hypertension diagnosis. 60%-83% of patients at each site had a urinalysis protein measurement within 7 days of SLE diagnosis. A normal or abnormal result for proteinuria could be derived for 96% of measurements, and nearly all patients with LN had ≥1 abnormal result (range 94%-100% by site). RAAS inhibitors were prescribed to 31% of SLE and 71% of LN patients (range 60%-84% by site). Hypertension, elevated BP or proteinuria was identified in 90% of SLE cases at the time of RAAS inhibitor initiation.ConclusionWe demonstrated the feasibility of ascertaining health measurement data relevant to pediatric lupus treatment and outcomes in a pediatric learning health system, as well as hospital-level variation in RAAS inhibitor use. This work will facilitate more efficient multi-institutional comparative effectiveness research and also highlights opportunities for increased treatment standardization.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"832-843"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110713","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}