Lupus Science & Medicine最新文献

{"title":"Perceptions of ageing among middle-aged and older adults with SLE: a single-centre cross-sectional study.","authors":"Sarah B Lieber, Yvonne Shea, Sarah P Gottesman, Amaya Smole, Neha G Nagpal, Julia Nguyen, Ashley Chung, Dongmei Sun, Iris Navarro-Millán, M Carrington Reid, Lisa A Mandl","doi":"10.1136/lupus-2025-001576","DOIUrl":"https://doi.org/10.1136/lupus-2025-001576","url":null,"abstract":"<p><strong>Objective: </strong>Negative self-perceptions of ageing are associated with decreased health-related quality of life (HRQoL) in older adults. We sought to characterise the association of self-perceptions of ageing, both positive and negative, with pain, depression and self-reported disability and frailty status in middle-aged and older adults with SLE.</p><p><strong>Methods: </strong>We enrolled adults ≥50 years with validated SLE in a single-centre cross-sectional study. Sociodemographic characteristics and disease features were self-reported. Self-perceptions of ageing were assessed using awareness of age-related change (AARC). We assessed patient-reported outcomes, disability and frailty status using the Patient-Reported Outcomes Measurement Information System 29-Item Profile (PROMIS-29), Valued Life Activities and Fatigue, Resistance, Ambulation, Illness, Loss of Weight Scale. Associations between AARC gains (ie, positive self-perception of ageing) and losses (ie, negative self-perception of ageing) and pain interference, depression, disability and frailty status (frail ≥3/5 criteria) were assessed using linear or logistic regression and adjusted for age, race, ethnicity, and SLE disease activity and organ damage.</p><p><strong>Results: </strong>Participants (n=80) were mostly female (95.0%) with mean age and SLE duration of 63.2 (SD=8.5) years and 23.1 (SD=14.5) years, respectively. Mean PROMIS-29 T-scores for pain interference and depression were 54.6 (SD=10.1) and 49.8 (SD=8.5), respectively; 29.9% were frail. After covariate adjustment, AARC losses, but not gains were significantly associated with pain interference (ß coefficient 0.94, 95% CI 0.33 to 1.54, p<0.01), depression (ß coefficient 0.67, 95% CI 0.04 to 1.30, p=0.04) and frailty (OR 2.09, 95% CI 1.30 to 3.37, p<0.01). After covariate adjustment, both AARC gains (ß coefficient -0.07, 95% CI -0.09 to -0.02, p<0.01) and losses (ß coefficient 0.08, 95% CI 0.03 to 0.12, p<0.01) were statistically significantly associated with disability.</p><p><strong>Conclusions: </strong>Negative self-perception of ageing was independently associated with decreased HRQoL among middle-aged and older adults with SLE. Addressing negative self-perceptions of ageing may improve HRQoL in this population.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NLR outperforms PLR in SLE diagnosis and prognosis: an AI-enhanced meta-analysis of 12 850 patients with ethnicity-specific cut-offs.","authors":"Naif Taleb Ali, Gamila Saleh Ali, Hana Mohsen Ali","doi":"10.1136/lupus-2025-001696","DOIUrl":"https://doi.org/10.1136/lupus-2025-001696","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the diagnostic and prognostic performance of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in SLE and to integrate these biomarkers into an interpretable artificial intelligence (AI) model for clinical decision support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;We conducted a two-phase mixed-methods study: (1) a meta-analysis of 50 studies (n=12 850 patients with SLE), compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and (2) the development and validation of an XGBoost machine learning model, guided by the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis-AI, with SHapley Additive exPlanations (SHAP) explainability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Our analysis used multicentre data from global SLE registries, including cohorts from Asia, Europe, North America and Africa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;The study included adults (≥18 years) who met the 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for SLE, with NLR and PLR measured via standardised complete blood count. Comparator groups consisted of healthy controls and patients with non-SLE autoimmune diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;NLR and PLR were assessed as biomarkers for SLE activity and complications. Our AI model integrated these ratios with standard clinical biomarkers and multi-omics data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Primary and secondary outcome measures: &lt;/strong&gt;The primary outcome was diagnostic accuracy (measured by area under the curve (AUC), sensitivity and specificity) for active SLE (defined as Systemic Lupus Erythematosus Disease Activity Index ≥6). Secondary outcomes included prognostic value (HRs for lupus nephritis, cardiovascular events and mortality) and treatment response monitoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our analysis demonstrated that NLR has superior diagnostic accuracy for active SLE compared with PLR, with a pooled AUC of 0.85 vs 0.78 (p=0.02). NLR showed pooled sensitivity and specificity of 78% and 82%, respectively, while PLR showed 70% and 75%. Elevated NLR (&gt;3.5) and PLR (&gt;185) predicted higher risks of lupus nephritis (HR=2.1 and 1.8, respectively), cardiovascular events (HR=2.3 and 1.9) and mortality (HR=3.1 and 2.1; all p&lt;0.01). We identified significant ethnic variations, with optimal NLR cut-offs of &gt;3.1 for Asian populations, &gt;2.8 for Caucasian populations and &gt;3.4 for African populations. The AI model achieved an AUC of 0.87 in training and 0.82 in validation, with NLR emerging as the top predictive feature (SHAP score=0.25).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;NLR outperforms PLR in SLE diagnosis and risk stratification, with validated cut-offs that vary significantly by ethnicity. The integration of these biomarkers into AI models enhances predictive accuracy, supporting the use of NLR and PLR as cost-effective tools for SLE management.&lt;/p","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential causal effect of SLE on osteoporosis, and the mediation effect: a Mendelian randomisation study.","authors":"Zhaoqing Wang, Jiaxuan Yang, Qingya Shi, Bojie Liu, Ying Liang, Yangzhong Zhou, Guanqiao Li","doi":"10.1136/lupus-2025-001735","DOIUrl":"10.1136/lupus-2025-001735","url":null,"abstract":"<p><strong>Objective: </strong>This study uses Mendelian randomisation (MR) to investigate the causal link between SLE and osteoporosis across different ethnic groups.</p><p><strong>Methods: </strong>Genetic variants associated with SLE were identified from publicly available genome-wide association studies in European and East Asian populations. Two-sample MR (TSMR) analysis and meta-analysis with inverse variance weighting (IVW) assessed their effects on bone mineral density (BMD) and fracture risk. Multivariable MR (MVMR) analysis in East Asians adjusted for potential mediators, and two-step mediation analysis evaluated mediation effects of independent covariates.</p><p><strong>Results: </strong>A meta-analysis of IVW results from TSMR in East Asian populations revealed a significant positive genetic association of SLE with osteoporosis (OR=1.023, CI 1.007 to 1.040, p<0.01). A similar, although weaker, association was observed in the European population (OR=1.001, CI 1.000 to 1.001, p<0.01). Furthermore, SLE was identified as a risk factor for reduced BMD in both East Asian (β=-0.0690, p<0.05) and European (β=-0.0109, p<0.05) populations, and for fracture risk in European (OR=1.002, p<0.05) populations, while no significant association was observed in the East Asian population (OR=1.010, p=0.705). MVMR analysis of East Asian data assessed mediation effects and found that the SLE-osteoporosis association was nullified after adjusting for cardiovascular disease and health status. Mediation analysis identified low-density lipoprotein cholesterol (LDL-C) and anti-inflammatory medication use as independent mediators, with mediation effects of 0.1170 and 0.0510, respectively. No significant heterogeneity or pleiotropy was detected.</p><p><strong>Conclusions: </strong>SLE appears to be a causal risk factor for osteoporosis. LDL-C and anti-inflammatory medication use mediate this relationship, suggesting the importance of managing these factors in patients with SLE to reduce osteoporosis risk.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of preterm delivery and early pregnancy hydroxychloroquine use from a Californian lupus cohort.","authors":"Amadeia Rector, Emily F Liu, Maurice Druzin, Michael H Weisman, Eliza Chakravarty, Miranda Cantu, Gary M Shaw, Daniel Z Kuo, Monique M Hedderson, Julia F Simard","doi":"10.1136/lupus-2025-001654","DOIUrl":"10.1136/lupus-2025-001654","url":null,"abstract":"<p><strong>Objective: </strong>Pregnant patients with systemic lupus erythematosus (SLE) have 2-3 times higher risk of preterm delivery (PTD). Hydroxychloroquine (HCQ) is recommended during pregnancy and may reduce PTD risk. This study investigates whether early pregnancy HCQ-use reduces PTD risk in a diverse SLE cohort.</p><p><strong>Methods: </strong>We included singleton pregnancies reaching ≥20 weeks' gestation (2011-2020) among patients with SLE aged 18-50 receiving care at Kaiser Permanente Northern California. HCQ exposure was defined as ≥2 prescriptions filled from 3 months before the last menstrual period through the first trimester. PTD was defined as delivery <37 weeks and continuously as gestational weeks for time-to-delivery analyses. Propensity scores (PS) based on demographics, comorbidities and medication use were calculated to address confounding. Risk ratios (RR) and HRs, including 95% CIs, were estimated using PS-adjusted Poisson regression with robust SEs and Cox regression, stratified by parity. To investigate effect modification, we stratified by prepregnancy comorbidities and pregnancy corticosteroid use.</p><p><strong>Results: </strong>Among 399 pregnancies in 324 patients, 21% were preterm. The PS-adjusted RR was 1.08 (95% CI 0.52 to 2.23) and 0.88 (95% CI 0.50 to 1.57) for nulliparous and multiparous pregnancies exposed to HCQ, respectively. The PS-adjusted HRs were similar, and results remained consistent across analyses stratified by potential effect modifiers.</p><p><strong>Conclusions: </strong>Although periconceptional HCQ-use was not associated with reduced PTD nor appreciably altered gestational age at delivery, we found no increased risks for these specific adverse outcomes. Consistent with other work, we found potentially protective associations in subsets stratified by parity. However, we had limited statistical power to test this.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of systemic lupus erythematosus associated with immune checkpoint inhibitors: a pharmacovigilance study using FAERS database.","authors":"Lan Zhen, Hong Chen, Wuyuan Pan, Jianrong Song, Huan Yi, Hong Zhou","doi":"10.1136/lupus-2025-001653","DOIUrl":"10.1136/lupus-2025-001653","url":null,"abstract":"<p><strong>Objectives: </strong>SLE associated with immune checkpoint inhibitors (ICIs) is rare, and a comprehensive profile of ICI-induced SLE remains poorly characterised. This study aimed to explore the potential association between ICIs and SLE and characterise clinical features.</p><p><strong>Methods: </strong>We extracted adverse event reports of patients with cancer with SLE from the FAERS (US Food and Drug Administration Adverse Event Reporting System) database (Q1 2011-Q4 2024). A disproportionality analysis was conducted using the reporting OR (ROR) and the information component, with adjusted ROR calculated via logistic regression to control for confounders.</p><p><strong>Results: </strong>146 066 ICI-related adverse events cases from patients with cancer were identified. Among these, 209 (median (IQR) age 63 (55.3-71.7) years; 106 (51%) female) cases of SLEs were reported. Our analysis detected significant positive signals for SLE associated with ICIs overall, particularly for anti-programmed cell death protein 1 (PD-1) and anti-programmed death-ligand 1 therapy. Eight positive signals of SLEs were identified, predominantly cutaneous lupus and SLE. The risk of ICI-related SLEs was significantly higher in females than in males. However, age and chemotherapy were not significant risk factors for the incidence of ICI-related SLEs. The risk was higher with anti-PD-1 therapy compared with other ICI therapies. Patients with lung cancer, melanoma or breast cancer appeared to be at higher risk. Most patients experienced serious outcomes, with a mortality rate of 4.31% (nine cases).</p><p><strong>Conclusion: </strong>This first pharmacovigilance study identified a significant association between ICI use and SLEs, suggesting ICIs may constitute a novel class of drug-induced SLE triggers. Personalised long-term safety monitoring for ICIs is warranted for high-risk patients (eg, females, anti-PD-1 recipients).</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and treatment response of patients with SLE complicated with thrombotic thrombocytopenic purpura.","authors":"Kai Zhang, Peng Zhao, Bo Huang, Yifan Wang, Taoran Bi, Peiliang Gao, Chunyu Wang, Xiaoyan Xing, Naidi Wang, Ruiling Feng, Gong Cheng, Haihong Yao, Yuan An, Yunshan Zhou, Yuebo Jin, Yuhui Li, Zhanguo Li, Jing He","doi":"10.1136/lupus-2025-001740","DOIUrl":"https://doi.org/10.1136/lupus-2025-001740","url":null,"abstract":"<p><strong>Background: </strong>SLE complicated with thrombotic thrombocytopenic purpura (SLE-TTP) is a rare but potentially fatal condition. Current studies regarding SLE-TTP are limited to case reports and literature reviews. This study presents a cohort of patients with SLE-TTP and aims to investigate their clinical characteristics and treatment outcomes, as well as to explore the efficacy of rituximab (RTX) maintenance therapy (RMT) for relapse prevention and long-term disease control.</p><p><strong>Methods: </strong>Patients with SLE-TTP were retrospectively identified in an SLE cohort. Baseline characteristics, acute-phase treatment responses and long-term outcomes were collected. All patients received RTX-containing induction therapy during the acute phase of TTP. Maintenance therapy was categorised as RMT (regular RTX infusions) or non-RMT (conventional immunosuppressants and/or biologics) regimens. TTP relapse, lupus low disease activity state (LLDAS) and infection rates were compared between groups.</p><p><strong>Results: </strong>Of 33 patients with SLE-TTP, 31 (94%) achieved clinical remission following RTX-containing induction therapy, while 2 died during the acute phase. Fourteen patients (45%) received RMT, and 17 (55%) received non-RMT regimens. During a median follow-up of 22.9 months, TTP relapse occurred in seven (23%) patients: one (7%) in the RMT group and six (35%) in the non-RMT group. Kaplan-Meier analysis revealed significantly longer relapse-free survival with RMT (log-rank p=0.027). All patients receiving RMT achieved LLDAS, compared with 59% of patients in the non-RMT group. Infection rates were comparable between the two groups.</p><p><strong>Conclusions: </strong>RTX-containing induction regimens resulted in high rates of clinical remission in patients with SLE-TTP. RMT was associated with a significantly reduced risk of TTP relapse and superior long-term control of SLE disease activity, without an excess risk of severe infection. These findings support RMT as a potential option for long-term management of SLE-TTP.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding determinants in Egyptian mothers with systemic lupus erythematosus or rheumatoid arthritis: a retrospective cohort study.","authors":"Omima Ahmed El-Farra, Amal Mohamed Elmesiry, Hager Adel Yehia Abdelfattah, Nermeen Mohammed Elmenayar, Ahmed Adel Abdel Azim, Ahmed Ibrahim Ewais, Gamal Saeed Gamal, Abrar Ghassan Mousa Balousha, Alaa Ali Awad","doi":"10.1136/lupus-2025-001733","DOIUrl":"10.1136/lupus-2025-001733","url":null,"abstract":"<p><strong>Objective: </strong>Breastfeeding prevalence and challenges among women of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) is under-researched especially in the Middle East-North Africa region. This study aimed to assess breastfeeding initiation, duration and predictors of early discontinuation (<6 months post partum) among Egyptian mothers with SLE or RA.</p><p><strong>Methods: </strong>This multicentre retrospective cohort study included 320 pregnancies: 62 SLE (105 pregnancies), 71 RA (110 pregnancies) and 59 healthy mothers (105 pregnancies). Data on pregnancy history, breastfeeding intent, initiation, duration and weaning reasons were collected.</p><p><strong>Results: </strong>Exclusive breastfeeding was lowest in SLE (29.9%) vs RA (50.6%) and controls (60%, p<0.001). Continuation beyond 6 months was significantly lower in SLE (36.2%) and RA (33.6%) vs controls (81%, p<0.001). Postpartum depression independently predicted discontinuation in SLE (adjusted OR (aOR)=0.06, 95% CI 0.01 to 0.6) and RA (aOR=0.34, 95% CI 0.13 to 0.9). Multivariable generalised estimating equation confirmed SLE reduced breastfeeding odds versus controls (aOR=0.41, p=0.040).</p><p><strong>Conclusion: </strong>Breastfeeding is significantly less prevalent among Egyptian mothers with SLE and RA when compared with control group. Targeted educational programme and support may help improve breastfeeding rates in SLE/RA mothers.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a minimal core dataset for systemic lupus erythematosus studies.","authors":"Stephen McDonald, Jialin Teng, Chengde Yang, Michelle Barraclough, Graciela S Alarcon, Anca D Askanase, Sasha Bernatsky, Ann Elaine Clarke, Nathalie Costedoat-Chalumeau, Qiang Fu, Dafna D Gladman, John G Hanly, Alexandra C Legge, David Isenberg, Kenneth Kalunian, Diane L Kamen, Michelle A Petri, Anisur Rahman, Chuanyin Sun, Ting Li, Murray Urowitz, Alexandre Voskuyl, Daniel J Wallace, Juan Zhang, Ian N Bruce","doi":"10.1136/lupus-2025-001595","DOIUrl":"10.1136/lupus-2025-001595","url":null,"abstract":"<p><strong>Objective: </strong>SLE is a complex, heterogenous autoimmune disease. SLE researchers do not always collect the same data, making comparative studies difficult. We aimed to ascertain what variables SLE clinical researchers commonly collect for SLE research. Our ultimate goal is to generate a minimal core dataset for future SLE studies.</p><p><strong>Methods: </strong>In 2020, we designed and distributed a questionnaire to members of the Systemic Lupus Erythematosus International Collaborating Clinics (SLICC) as well as additional active research centres in China. Our survey included 26 questions about the types of data that are routinely collected for research. Variables collected by ≥75% of participating respondents were used as a threshold for inclusion.</p><p><strong>Results: </strong>18 of 36 invited respondents replied (8 from USA/Canada, 5 from China and 5 from Europe). Many key variables in the domains of sociodemographics, SLE specific, comorbidities, baseline haematology/biochemistry/immunology and treatment data were collected by ≥75% respondents including the 1997 American College of Rheumatology (ACR) Classification Criteria (83%), SLE Disease Activity Index-2000 (82%), current treatment (100%), drug name, dose, frequency and start date (75-100%) and complement C3/4 (94%). A range of other items was collected by 50-<75% of respondents including SLICC 2012 Criteria (67%), SLICC/ACR Damage Index (68%) and Short Form Health Survey-36 (53%). Less than 50% of respondents collect certain items including European Alliance of Associations for Rheumatology/ACR 2019 criteria (33%), British Isles Lupus Assessment Group scores (12%) and pneumococcal vaccine status (39%).</p><p><strong>Conclusions: </strong>The frequency with which an initial set of variables is collected in SLE cohorts globally was identified and can form the basis from which to develop a core minimum dataset for SLE. Further refinement and common definitions will be needed to finalise a minimal core dataset suitable for widespread use.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 disease-modifying antirheumatic drug selection with hospitalised infection among youth with childhood-onset systemic lupus erythematosus.","authors":"Jordan E Roberts, Anna V Faino, Marshall Brown, Gabrielle Alonzi, Mersine A Bryan, Cordelia Burn, Joyce C Chang, Jonathan D Cogen, Nidhi Naik, Kareena Patel, Emily Zhang, Esi M Morgan, MaryBeth Son","doi":"10.1136/lupus-2025-001607","DOIUrl":"10.1136/lupus-2025-001607","url":null,"abstract":"<p><strong>Objective: </strong>Youth with childhood-onset SLE (cSLE) have increased risk of serious infection. It is unknown how much of this risk is due to modifiable factors such as choice of immunosuppressant. We aimed to compare hospitalised infection rates in youth with cSLE on different disease-modifying antirheumatic drugs (DMARDs).</p><p><strong>Methods: </strong>We included youth ≤18 years with cSLE treated from 2009 to 2022 at two centres. Clinical data were extracted from electronic health records and the Paediatric Health Information System. Hospitalised infection frequency was calculated over the first year of treatment in youth included in each DMARD exposure group, stratified by lupus nephritis (LN) status. Cox proportional hazard regression with inverse probability of treatment weighting (IPTW) was used to compare infection rates across DMARD groups, adjusting for corticosteroid dose.</p><p><strong>Results: </strong>Among 257 youths with cSLE, 5% had ≥1 hospitalised infection within 1 year of DMARD initiation. 8% of those with LN had ≥1 hospitalised infection compared with 2.5% without LN. In IPTW-adjusted models, children with LN treated with mycophenolate had lower risk of infection compared with those treated with cyclophosphamide (HR 0.12; 95% CI 0.019 to 0.88). Among those without LN, mycophenolate did not differ from azathioprine in infection risk (HR 1.67, 95% CI 0.56 to 4.99). Higher oral corticosteroid dosing (per 1 mg/day of prednisone) was associated with increased risk of infection (HR 1.1, 95% CI 1.05 to 1.15).</p><p><strong>Conclusions: </strong>We observed higher hospitalised infection rates in children with cSLE and LN compared with those without LN. Among children with LN, those who received cyclophosphamide had more infections than those who received mycophenolate. Methotrexate was associated with lower infection rates than mycophenolate or azathioprine among youth without LN. Higher daily oral steroid dose was significantly associated with increased hospitalised infection risk in youth with non-renal SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12458716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TSPO PET/MR in neuropsychiatric lupus: neuroinflammatory metabolic signatures and diagnostic biomarkers.","authors":"Jing Huang, Jiyuan Wang, Bixiao Cui, Li Su, Hongwei Yang, Yu Liu, Hongxing Wang, Jie Lu","doi":"10.1136/lupus-2025-001643","DOIUrl":"10.1136/lupus-2025-001643","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric SLE (NPSLE) is a clinically challenging subset of SLE, marked by heterogeneous central nervous system involvement. Diagnosis relies on clinical symptoms and exclusionary criteria, lacking objective biomarker.</p><p><strong>Purpose: </strong>To investigate metabolic patterns of intracerebral lesions and identify diagnostic biomarkers for NPSLE using translocator protein (TSPO) positron emission tomography (PET)/magnetic resonance (MR).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 19 patients with NPSLE and 10 patients with non-NPSLE, who underwent [¹⁸F] DPA-714 PET/MRI. Diagnoses of SLE and NPSLE followed American College of Rheumatology (ACR) classification and Systemic Lupus International Collaborating Clinics (SLICC) Model B criteria. T2-weighted MRI lesions served as regions of interest (ROI), coregistered to PET for cross-modality quantitative analysis. The maximum uptake (SUVmax) and mean uptake (SUVmean) of brain lesions for each patient was measured. Group differences in SUVmax and SUVmean were compared. Clinical associations were conducted using Pearson correlation, and differentiation between non-NPSLE and NPSLE was performed by logistic regression analysis.</p><p><strong>Results: </strong>SUVmax was significantly higher in the NPSLE group than in the non-NPSLE group (p<0.01), while there was no significant difference in SUVmean (p>0.05). SUVmax was correlated with clinical assessment scores (SLICC/ACR: r=0.43, p=0.02; modified Rankin Scale: r=0.41, p=0.04; SLE Disease Activity Index: r=0.41, p=0.03), and no significant correlation was found for SUVmean. In logistic regression analysis, only the model based on SUVmax alone was significant (p=0.01). In ROC analysis, the area under the curve (AUC) of SUVmax (0.83) was higher than that of SUVmean (0.68), and Model 4 (SUVmax+SUVmean + Interaction) showed the best diagnostic performance (AUC=0.94).</p><p><strong>Conclusions: </strong>Patients with NPSLE and non-NPSLE showed distinct TSPO uptake in brain lesions, indicating different pathophysiology. TSPO PET/MR may serve as a potential imaging biomarker for differentiating NPSLE, providing insights for clinical diagnosis and mechanistic stratification in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}