Lupus最新文献

{"title":"Clinical characteristics of patients with late-onset systemic lupus erythematosus with a disease onset of ≤ 3 months.","authors":"Mengxue Yan, Siping Li, Jingyi Lu, Zhichun Liu, Leixi Xue","doi":"10.1177/09612033261481990","DOIUrl":"https://doi.org/10.1177/09612033261481990","url":null,"abstract":"<p><p>ObjectivesThis study aimed to explore the clinical characteristics of patients with late-onset systemic lupus erythematosus (SLE) during the initial stage of disease onset and to evaluate disease activity.MethodData from patients with SLE whose disease onset was ≤3 months were retrospectively collected, and the patients were classified into the late- and early-onset SLE groups based on an age cutoff of 50 years.ResultsThis study included 145 patients, including 31 with late-onset SLE and 114 with early-onset SLE. Compared with the early-onset SLE group, the late-onset SLE group had a lower prevalence of rash (25.8% vs. 45.6%, <i>p</i> = 0.040) and anti-dsDNA antibody positivity (54.8% vs. 72.5%, <i>p</i> = 0.027), whereas pericarditis was more frequent (29.0% vs. 12.3%, <i>p</i> = 0.047) and the C3 levels were higher (0.640 [0.400, 0.892] g/L vs. 0.460 [0.324, 0.701] g/L, <i>p</i> = 0.018). As regards disease activity, the SLEDAI 2000 was 10 (8, 20) in the late-onset SLE group and 15 (10, 22) in the early-onset SLE group (<i>p</i> = 0.066), whereas the SLE-DAS was similar between the groups (13.33 [11.50, 28.45] vs 15.48 [8.56, 25.18], <i>p</i> = 0.744). More than half of patients with late-onset SLE received high-dose or intravenous pulse corticosteroid therapy, with no statistically significant difference compared with patients with early-onset SLE.ConclusionsPatients with very early-stage late-onset SLE exhibited distinct clinical and serological features. However, their disease activity was essentially consistent with that of early-onset SLE, and they often require intensive immunosuppressive therapy.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261481990"},"PeriodicalIF":1.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808528","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":"Beyond clinical renal remission: Serological and obstetric risk stratification in lupus nephritis.","authors":"Luisa Del Carmen Ruiz-Figueroa, David A Herrera-vanOostdam, Carlos Abud-Mendoza","doi":"10.1177/09612033261481993","DOIUrl":"https://doi.org/10.1177/09612033261481993","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261481993"},"PeriodicalIF":1.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808543","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":"IFI44L promoter hypomethylation as an epigenetic biomarker of systemic lupus erythematosus: A systematic review and meta-analysis.","authors":"Kainat Sheraz, Aasiyah Fagbo, Rahemeen Siddique, Leen Alhodathi, Wahidullah Sheraz, Muhammad Ahmed Usman, Mazhar Mushtaq","doi":"10.1177/09612033261479099","DOIUrl":"https://doi.org/10.1177/09612033261479099","url":null,"abstract":"<p><p>BackgroundSystemic Lupus Erythematosus (SLE) is a heterogeneous autoimmune disease characterized by dysregulated type I interferon signaling. Epigenetic alterations, particularly DNA methylation changes in interferon-regulated genes, have emerged as promising biomarkers for disease diagnosis and stratification. Among these, IFI44L promoter hypomethylation has been repeatedly reported as one of the most consistent and disease specific in SLE.ObjectiveTo systematically evaluate the evidence on IFI44L promoter methylation in SLE and to quantitatively synthesize its epigenetic and diagnostic performance across diverse populations using meta-analytic approaches.MethodsA systematic search of published literature was conducted to identify studies reporting IFI44L promoter methylation in patients with SLE and controls. Study characteristics, ethnicity, cell type, direction of methylation, CpG hypo/hyper methylation counts were extracted. Descriptive analyses were performed across ethnicities and cell types. Diagnostic performance was summarized as the pooled area under the receiver operating characteristic (ROC) curve (AUC). Variance of AUC estimates was approximated using the Hanley-McNeil method, and a random-effects meta-analysis (DerSimonian-Laird) was applied to account for between-study heterogeneity.Results16 study datasets reporting hypomethylation of the IFI44L promoter were included. IFI44L promoter hypomethylation was consistently observed across ethnic groups and biological sample types. Descriptive subgroup analyses identified heterogeneity in the magnitude of IFI44L promoter hypomethylation across ethnic groups, study periods, and methylation profiling methodologies, whereas differences according to biological sample type were less pronounced and did not reach statistical significance. Hypomethylation predominated over hypermethylation among studies reporting both methylation directions. Diagnostic AUC values varied across studies but were largely independent of sample size and the magnitude of hypomethylation. The pooled area under the curve (AUC) was 0.74 (95% CI 0.64-0.84), indicating moderate overall diagnostic performance.ConclusionIFI44L promoter hypomethylation represents a significant and reproducible epigenetic signature of SLE across populations and study designs. Despite variability in methylation magnitude, its diagnostic performance remains consistent, supporting IFI44L methylation as a promising biomarker for SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033261479099"},"PeriodicalIF":1.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795083","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":"Evaluating the readability and comprehension of patient education materials for Systemic Lupus Erythematosus (SLE) available online.","authors":"Nagoor Shaik, Ugochukwu C Nweke, Meenakshi Jolly","doi":"10.1177/09612033261458430","DOIUrl":"10.1177/09612033261458430","url":null,"abstract":"<p><p>ObjectiveWe evaluated the reading & comprehension levels of Systemic Lupus Erythematosus (SLE) Patient educational materials (PEMs) available online, from both nonprofit and for-profit organizations.MethodsWe analyzed PEMs from four nonprofit organizations (American College of Rheumatology [ACR], Lupus Foundation of America [LFA], Lupus Research Alliance [LRA], Lupus Society of Illinois [LSI]) & three for-profit company's platforms (Aurinia, AstraZeneca, GlaxoSmithKline [GSK]). Reading & comprehension scores were calculated using six standard tools, and comparisons were performed using one-way ANOVA & Tukey's post-hoc analysis. A <i>p</i>-value ≤0.05 was considered statistically significant.ResultsThe average Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES) across all PEMs were 10.05 ± 0.70 and 52.68 ± 4.10, respectively. Materials from nonprofit organizations had a FKGL of 10.35 ± 0.88 and a FRES of 51.19 ± 4.91, indicating a reading level requiring 10th- to 12th-grade proficiency. For-profit organizations had a slightly lower FKGL of 9.98 ± 0.42 and a higher FRES of 54.35 ± 2.65. These differences were not statistically significant (<i>p</i> = 0.53 and 0.16). However, significant within-group differences were observed. Among nonprofits, PEMs from LFA had the most favorable readability metrics (FKGL 9.19 ± 0.44, FRES 58.34 ± 3.11), compared to ACR (10.64 ± 0.56, 49.81 ± 2.24), LRA (10.53 ± 0.61, 50.54 ± 2.69), and LSI (11.28 ± 0.45, 45.64 ± 2.03) (<i>p</i> < 0.01). Among for-profits, PEMs from Aurinia had significantly better readability scores (FKGL 9.59 ± 0.46, FRES 55.77 ± 3.05) than those from AstraZeneca (9.93 ± 0.38, 53.13 ± 2.48) and GSK (9.86 ± 0.25, 54.28 ± 2.16) (<i>p</i> < 0.001).ConclusionMost SLE patient education materials available online are written at or above a 10th-grade level. These findings highlight the urgent need to improve PEM readability to support patients with lower health literacy.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"939-947"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205326","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":"MiR-429 influences the development of systemic lupus erythematosus nephritis by targeting SORT1.","authors":"Qiujun Guo, Shuilan Qiu","doi":"10.1177/09612033261452900","DOIUrl":"10.1177/09612033261452900","url":null,"abstract":"<p><p>PurposeSystemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by immune dysregulation, inflammation, and organ damage, particularly affecting the kidneys. This study aimed to investigate the role of miR-429 and its target gene SORT1 in the pathogenesis of SLE, focusing on their effects on immune cell balance, inflammation, and kidney injury.MethodsDifferential expression of miRNAs in SLE and lupus nephritis (LN) was analyzed using the GEO database, with identifying miR-429 as a potential regulator. In vitro, human mesangial cells (HMCs) were treated with TGF-β1 to investigate the effects of miR-429 and SORT1 on HMCs function in SLE. In vivo, a MRL/lpr mice were used as an SLE model to assess the impact of miR-429 on immune cell populations, inflammatory cytokine levels, and kidney pathology. Various assays, including qPCR, flow cytometry, CCK-8, and histological staining, were employed to evaluate gene expression, cell proliferation, and tissue damage.ResultsmiR-429 was downregulated in SLE patients and identified as a regulator of SORT1. In vitro, miR-429 expression decreased while SORT1 expression increased in TGF-β1-treated HMCs. Overexpression of miR-429 inhibited HMCs proliferation and reduced levels of IL-1β, IL-6, and TNF-α; however, these effect were reversed by SORT1 overexpression. In vivo, miR-429 treatment alleviated kidney damage in SLE mice, decreased levels of inflammatory cytokines, urinary albumin, uACR, SCr, and BUN, increased levels of Nephrin, Podocin, and WT1, and improved kidney histology. Conversely, co-overexpression of miR-429 and SORT1 attenuated these protective effects. Furthermore, miR-429 overexpression restored the balance between Th17 and Treg cells in SLE mice, whereas SORT1 overexpression suppressed this restoration.ConclusionmiR-429 targets SORT1 to modulate immune responses, reduce inflammation, and protect against kidney damage in SLE, suggesting that targeting the miR-429/SORT1 axis may offer a promising therapeutic strategy for SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"927-938"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942166","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":"Skin involvement in the catastrophic antiphospholipid syndrome: A review from CAPS registry.","authors":"A Ponce, I Rodríguez-Pintó, I Pons, A Jerez, P Toledano, T Rossiñol, B Vilaplana, G Espinosa, R Cervera","doi":"10.1177/09612033261461987","DOIUrl":"10.1177/09612033261461987","url":null,"abstract":"<p><p>ObjectiveTo describe the prevalence, clinical manifestations, histopathological features, and antibody profile associated to skin involvement in patients with catastrophic antiphospholipid syndrome (CAPS).MethodsWe performed a cross-sectional study of the patients included in the \"CAPS Registry,\" a registry developed by the European Forum on Antiphospholipid Antibodies (aPL)1,2 This database contains data from patients with CAPS collected from April 1992 to December 2024. Demographic clinical manifestations, laboratory features (including aPL antibodies), pathological findings in involved skin, and outcome were retrieved.ResultsCutaneous involvement was described in 377 episodes (47%) from 361 patients. A female sex prevalence of 49.4% was observed. The average age was 39.4 (SD ± 17.9) years. The more frequent skin manifestations observed were livedo reticularis (17.6%), skin necrosis (13%), ischemic ulcers (10.4%), skin ischemic (9.7%), skin purpura (7.1%), gangrene (5%), splinter haemorrhages (2.6%), and Raynaud's phenomenon (1.5%). The most frequently affected organs in CAPS episodes with skin involvement were kidneys (72%), lungs (61%), central nervous system (54.5%), and heart (54.4%). Thrombocytopenia and hemolysis features were more common in patients with skin involvement (p < 0.05 for all). Thrombotic microangiopathy was the predominant pathological finding, present in 82 (68.3%) episodes. No difference regarding mortality were found in episodes with or without skin involvement (29.3% vs 32.1%, p = 0.42).ConclusionThe presence of skin involvement in patients with CAPS is frequent. The most frequent manifestations were livedo reticularis and skin necrosis. Skin involvement does not seem to be associated to mortality.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"972-977"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252109","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":"Geographic distribution of mortality from systemic lupus erythematosus.","authors":"Amnon Sonnenberg, Anna M Buchner","doi":"10.1177/09612033261449992","DOIUrl":"10.1177/09612033261449992","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematous (SLE) shares many common epidemiologic features with other autoimmune diseases or diseases associated with an underlying Epstein-Barr virus (EBV) infection. It was hypothesized that the geographic variation of mortality from SLE would reveal a similar pattern as Hodgkin lymphoma (HL), multiple sclerosis (MS), Crohn's disease (CD), and ulcerative colitis (UC).MethodsUsing the vital statistics of 21 countries from 1951-2022, overall and age-specific death rates from the 5 diseases were calculated for each individual country. The death rates of different countries were compared using linear regression analysis.ResultsWhereas other autoimmune diseases or diseases associated with an underlying EBV infection, such as HL, MS, CD, and UC, showed remarkably similar geographic variations, the geographic distribution of SLE did not fit this overall pattern. High death rates from SLE were not clearly associated with developing versus developed countries, northern versus southern latitude, or any specific continent. However, similar geographic distributions of SLE were consistently found among consecutive age groups, ranging from 0-4 to 85+ years.ConclusionsThe similarities in the geographic distributions of death rates from HL, MS, CD, and UC suggest that these 4 diseases share a set of one or more common environmental risk factors. Other environmental risk factors besides EBV infection must contribute to the varying occurrence of SLE across the globe. These risk factors start exerting their influence at a very young age of less than 5 years.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"910-917"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816935","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":"Artificial intelligence in the care of systemic lupus erythematosus: Current capabilities and translational barriers.","authors":"Camillo Tancredi Strizzi, Wisit Cheungpasitporn, Charat Thongprayoon, Francesco Pesce","doi":"10.1177/09612033261454511","DOIUrl":"10.1177/09612033261454511","url":null,"abstract":"<p><p>BackgroundThe clinical heterogeneity of systemic lupus erythematosus exceeds the resolution of conventional disease activity instruments. Artificial intelligence offers the analytical infrastructure to engage with this complexity, yet the translation of AI models into clinical practice remains limited.MethodsThis review critically appraises the current evidence for AI applications across the SLE clinical workflow, including computational phenotyping, diagnosis, disease activity monitoring, organ-specific predictive modelling, and treatment personalization. Studies were evaluated for external validation, prospective testing, algorithmic fairness, explainability, and regulatory status.FindingsAI applications across the SLE clinical workflow show uneven methodological maturity. Diagnostic and monitoring tools include the SLERPI index, with multinational external validation, and an LSTM flare-prediction model (C-index 0.897). Treatment personalization is anchored by serum IgA2 anti-dsDNA, the only SLE response biomarker validated across independent trials, and by multi-stain deep learning on renal biopsies (AUC 0.84, three external centers). Predictive modelling for organ-specific manifestations has progressed unevenly: cardiovascular risk stratification (SLECRISK) and a multicenter thrombocytopenia model are the most mature, while neuropsychiatric, gastrointestinal, and ocular applications remain single-center proofs of concept. External validation is the exception across SLE prediction models, no AI tool has received regulatory clearance, and populations most affected by SLE remain underrepresented in training data.ConclusionsAI demonstrates genuine analytical capability in SLE but the translation gap is defined by insufficient validation, limited explainability, and absent equity evidence. Closing it will require fewer published models and more validated tools, optimization for clinical impact rather than discrimination alone, and demonstration of performance equity across the demographic spectrum of the disease.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"885-898"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981996","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":"Outcomes of systemic lupus erythematosus hospitalisations in Qatar: Insights from a multinational tertiary centre experience.","authors":"Miral H Gharib, Karima Becetti, Hana J Abukhadijah, Fiaz Alam, Aishwariya Padmakumari, Mohamed Al-Kahlout, Rawan Saleh, Muhammad Bilal Jamshaid, Samar Al-Emadi","doi":"10.1177/09612033261458573","DOIUrl":"10.1177/09612033261458573","url":null,"abstract":"<p><p>ObjectiveSystemic lupus erythematosus (SLE) is a chronic autoimmune disorder associated with considerable morbidity and mortality, particularly due to frequent hospitalisations. This study aimed to describe the causes, clinical course, and outcomes of hospitalisations among patients with SLE in a multinational cohort.MethodsThis retrospective cohort included adults (aged ≥18 years) with SLE hospitalised at Hamad General Hospital, Qatar, between June 2016 and August 2020. Each admission was considered separately. Data included demographics, clinical features, SLE Disease Activity Index (SLEDAI), serological markers, complications, treatments, and prognoses. Predictors of intensive care unit (ICU) admission were evaluated using univariable and multivariable logistic regression.ResultsThere were 281 admissions among 153 patients. Most patients (87%) were female, with a median age of 34 years (IQR: 26-44). The principal causes of admission were lupus flares, haematologic (38%), renal (28%), and articular (20%), followed by infection (20%). The median hospital stay was 7 days (IQR: 4-12). Re-admission occurred in 51% of the patients, and 17% of the admissions required ICU care. ICU admission was associated with a longer hospital stay (median 16 vs 6 days, <i>p</i> < 0.001) and higher mortality (11% vs 0%, <i>p</i> < 0.001). Factors predicting ICU admission were a higher SLEDAI score (odds ratio (OR) 1.14, 95% confidence interval (CI)1.07-1.21, <i>p</i> < 0.001), sepsis (OR 4.91, 95% CI 2.02-11.89, <i>p</i> < 0.001), and cardiac involvement (OR 7.57, 95% CI 1.74-32.93, <i>p</i> = 0.007).ConclusionsIn this multinational cohort, SLE flares and infections were the leading causes of hospitalisation. Sepsis, comorbid conditions, and high disease activity are associated with adverse outcomes. Optimising disease control, preventing infection, and managing comorbidities are essential to improve hospitalisation outcomes and reduce mortality.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"983-991"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218021","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":"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":"918-926"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320137/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}