Lupus Science & Medicine最新文献

{"title":"Impact of an online lupus self-management programme in an established, population-based cohort of adults with diagnosed SLE: a mixed-methods study.","authors":"Sarah D Gilman, Sara Johnson, Gaobin Bao, Charmayne Marie Dunlop-Thomas, Katherine Carpenter, Melissa French, Cristina Drenkard, Melicent Miller, Mary Crimmings, S Sam Lim","doi":"10.1136/lupus-2025-001711","DOIUrl":"https://doi.org/10.1136/lupus-2025-001711","url":null,"abstract":"<p><strong>Objective: </strong>Strategies to Embrace Living with Lupus Fearlessly (SELF) is an online self-management education programme for people with SLE. This mixed-methods study examines SELF's impact on patient-reported outcomes while assessing implementation outcomes informing feasibility and dissemination.</p><p><strong>Methods: </strong>A convergent mixed-methods design was used, merging qualitative and quantitative data to enhance interpretation. The Reach, Effectiveness, Adoption, Implementation and Maintenance evaluation framework was used to evaluate programme feasibility and sustainment potential. Participants were recruited from the Georgians Organized Against Lupus (GOAL) cohort (Georgia).</p><p><strong>Results: </strong>221 adults with SLE from the GOAL cohort enrolled in SELF, completing patient-reported assessments at baseline and 90-day follow-up. 12 participants also completed in-depth interviews exploring the impact of the programme. Certain subgroups including black participants (n=193; 95% CI=-1.59 to -0.04), those with high fatigue levels (n=164; 95% CI=-1.85 to -0.11) and participants living below 100% of the federal poverty level (n=74; 95% CI=-3.44 to -0.18) reported significantly lower disease activity at 90-day follow-up after engaging with SELF. High-fatigue participants improved on multiple measures while the low-fatigue group showed unexpected declines that may reflect baseline confounding. Qualitative findings generally supported quantitative results. One exception was self-efficacy in managing medications, which showed a small but significant decrease (mean reduction=-1.38, 95% CI=-2.50 to -0.26, Cohen's d=-0.14). However, qualitative data suggested participants became more aware of skill gaps rather than less capable.</p><p><strong>Conclusions: </strong>SELF showed promising results for reducing disease activity, pain and fatigue among specific subgroups of participants with SLE. Further research should broaden the evaluation of SELF to new geographical settings, broader populations (such as people living with lupus in rural healthcare settings) and further testing for cultural relevance across diverse racial and ethnic groups.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839776","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":"Anti-CD19 monoclonal antibody for systemic lupus erythematosus and neuromyelitis optica spectrum disorder.","authors":"Pamela Gonzalez Manrique, Isabelle Ayoub, Tirisham Gyang, Judith Lin","doi":"10.1136/lupus-2025-001919","DOIUrl":"https://doi.org/10.1136/lupus-2025-001919","url":null,"abstract":"","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839813","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":"Double humanised lupus mouse model with human immune system and faecal microbiota from patients with SLE.","authors":"Tian Xu, Ran Lu, David N Oakland, Rana Estaleen, Amelia Rawlings, Hilary Montano, Santiago Diab, Jacquelyn S Michaelis, Mihai Pop, Adegbenga Bankole, Christopher M Reilly, Xin M Luo","doi":"10.1136/lupus-2026-001982","DOIUrl":"https://doi.org/10.1136/lupus-2026-001982","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to create a double humanised lupus mouse model with a human immune system and faecal microbiota from patients with SLE.</p><p><strong>Methods: </strong>We established the Double humanised SLE (DhuSLE) mouse by engrafting NSG immunodeficient mice with human CD34⁺ haematopoietic stem and progenitor cells (NSG-hu mice) and performing faecal microbiota transplantation from patients with SLE (SLE-FMT).</p><p><strong>Results: </strong>While FMT in general transiently suppressed the development of human T cells in NSG-hu mice, SLE-FMT but not FMT from non-SLE donors promoted superficial skin lesions. Importantly, the combination of SLE-FMT and pristane in NSG-hu, now called the DhuSLE-P mouse, induced proteinuria although this clinical sign observed in mice did not reflect that of the microbiota donors. DhuSLE-P mice exhibited a higher level of human IgM in the circulation than NSG-hu mice, which was positively correlated with the frequency of plasma cells in the spleen. In the splenic sections of DhuSLE-P mice, nuclear BCL6 was minimally detected but CD138 expression was evident, suggesting that most plasma cells generated were not class switched and produced IgM. Some human IgG was detected in the kidney of DhuSLE-P mice with a trend towards increased total IgG in the serum. Analysis of the faecal microbiota revealed that the gut microbiota compositions were different between DhuSLE-P mice and NSG-hu mice due to SLE-FMT but not the injection of pristane.</p><p><strong>Conclusion: </strong>Together, these results introduced the first humanised lupus mouse model combining the human immune system and gut microbiota from patients with SLE. However, limitations exist and the model may benefit from methods that promote antibody class switching. On further development, the DhuSLE model can be useful for elucidating mechanisms and/or evaluating SLE treatments.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839792","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":"Reference intervals for aCL and anti-β2GPI IgAGM antibodies in a large health-inspection population: a foundational study for combined-isotype assay interpretation.","authors":"Guixiang Sun, Mengyu Tao, Fengxia Gong, Sanxing Wang, Xiaopan Gao, Letong Zhang, Xinxiu Liang, Heqiang Sun","doi":"10.1136/lupus-2025-001889","DOIUrl":"https://doi.org/10.1136/lupus-2025-001889","url":null,"abstract":"<p><strong>Objectives: </strong>Combined-isotype anticardiolipin (aCL) and anti-β2-glycoprotein I (anti-β2GPI) immunoglobulin A, G and M (IgAGM) assays are used in current laboratory practice, but their disease relevance and clinical interpretation remain incompletely defined. This study aimed to establish 99th-percentile reference intervals for aCL IgAGM and anti-β2GPI IgAGM in a large general healthy population and to provide a basis for future disease-oriented evaluation.</p><p><strong>Methods: </strong>A total of 7846 eligible individuals who underwent health inspection were included in the analysis. Plasma aCL IgAGM and anti-β2GPI IgAGM were measured by ELISA. A physiologically normal reference subgroup was defined by excluding predefined laboratory abnormalities at the retained index visit (n=989). Retrospective contextual analyses were also performed in systemic lupus erythematosus (SLE) and coronary heart disease (CHD) populations with historical IgAGM results.</p><p><strong>Results: </strong>Among 7846 individuals (5170 male and 2676 female; age 15-90 years), the 99th percentiles were 35.4 relative units (RU)/mL for aCL and 51.7 RU/mL for anti-β2GPI. In the physiologically normal reference subgroup, the corresponding values were 23.33 RU/mL and 46.25 RU/mL. Sex differences were significant for both antibodies in the overall population and in the physiologically normal subgroup, and aCL showed age-related increases at the upper tail. In retrospective analyses, SLE showed higher proportions above all four cut-offs than CHD, with significance for anti-β2GPI at both the general health participant cut-off (11.4% vs 4.5%, p=0.0425) and the physiologically normal cut-off (12.3% vs 4.5%, p=0.0200). Exploratory analyses linked antibody levels to triglyceride-related profiles.</p><p><strong>Conclusions: </strong>Assay-specific 99th-percentile reference intervals for aCL IgAGM and anti-β2GPI IgAGM were established in a large health-inspection population and a physiologically normal reference subgroup. These findings provide a practical interpretive framework for combined-isotype assays and support future disease-oriented evaluation.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839754","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":"Controlling cardiovascular risk factors reduces progression of atherosclerosis in a multiethnic cohort of patients with lupus.","authors":"Jyoti Bakshi, Rym Abida, Sara Croca, Maura Griffin, Kunal Chandwar, Filipa Farinha, Thomas McDonnell, David Isenberg, Andrew Nicolaides, Anisur Rahman","doi":"10.1136/lupus-2026-001999","DOIUrl":"https://doi.org/10.1136/lupus-2026-001999","url":null,"abstract":"<p><strong>Objective: </strong>Patients with SLE have increased risk of both clinical cardiovascular disease (CVD) and subclinical atherosclerosis. Reports have shown that controlling CVD risk factors reduces subclinical plaque progression in patients with SLE. We investigated whether this finding was confirmed in our ethnically diverse cohort of patients, measuring total plaque area (TPA) as well as the number of plaques.</p><p><strong>Methods: </strong>69 patients with SLE underwent ultrasound scans of the carotid and common femoral arterial bifurcations on two occasions (mean 63 months apart). Clinical, demographic, CVD risk and treatment factors were recorded for each patient. Change in plaque number and increase in TPA between scans were the outcome measures.</p><p><strong>Results: </strong>31 patients had plaque at the second scan. 13 had unchanged number of plaques while 18 had increased plaque numbers including six who were initially free of plaque. All 31 patients had increased TPA with median increase 4.59 mm²/year (IQR 2.4-7.33) and these patients were subdivided into two groups with change in TPA above or below the median. Factors associated with both increased plaque number and above-median TPA increase at the second scan compared with the first were age at baseline, positive lupus anticoagulant, negative anti-La and failure to attain at least three CVD risk targets within the follow-up period between scans. We found no associations with disease activity or medication.</p><p><strong>Conclusion: </strong>In this ethnically diverse (40% non-Caucasian) population, we confirmed earlier findings that better control of CVD risk targets reduces progression of atherosclerotic plaque. Anti-La positivity was associated with less plaque progression, which was unexpected.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839816","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":"Efficacy of belimumab in patients with SLE and haematological manifestations: retrospective analysis from the BeRLiSS 2.0 cohort.","authors":"Greta Hulej, Federico Arru, Benedetta Bianchi, Alessandra Bortoluzzi, Luisa Brussino, Paola Castrignanò, Alberto Cauli, Lorenzo Cavagna, Elisabetta Chessa, Emanuele Chiara, Rossella De Angelis, Ginevra De Marchi, Roberto Depascale, Marco Di Carlo, Giacomo Emmi, Isotta Galvagni, Michela Gasparotto, Mariele Gatto, Roberto Gerli, Marcello Govoni, Alberto Lo Gullo, Alessia Nano, Simone Negrini, Silvia Noviello, Giovanni Orsolini, Giulia Pazzola, Matteo Piga, Luca Quartuccio, Maurizio Rossini, Carlo Salvarani, Ettore Silvagni, Elena Silvestri, Marianna Tamussin, Martina Tizian, Paola Tomietto, Maria Letizia Urban, Angelo Vacca, Filippo Vesentini, Marisol Bracalenti, Roberta Ramonda, Andrea Doria, Luca Iaccarino, Margherita Zen","doi":"10.1136/lupus-2025-001934","DOIUrl":"https://doi.org/10.1136/lupus-2025-001934","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of belimumab (BEL) in improving anaemia, thrombocytopenia, lymphopenia and leucopenia in patients with SLE.</p><p><strong>Methods: </strong>The BeRLiSS (Belimumab in Real Life Setting Study) 2.0 cohort included patients with SLE from 14 Italian referral centres treated with BEL for active joint or skin involvement, based on physician judgement, between June 2013 and May 2024. Clinical and laboratory parameters were recorded at baseline and every 6 months. Patients were eligible if they had baseline haematological abnormalities defined according to British Isles Lupus Assessment Group (BILAG) (grade C or higher): haemoglobin (Hb) ≤10.9 g/dL, platelets (Plts) ≤149×10⁹/L, lymphocytes (Lym) ≤1.0×10⁹/L or leucocytes (Leuc) ≤3.0×10⁹/L. Follow-up data up to month 48 were available for 33 patients with anaemia, 20 with thrombocytopenia, 44 with lymphopenia and 18 with leucopenia.</p><p><strong>Results: </strong>At baseline, 76 patients had anaemia, 44 thrombocytopenia, 107 lymphopenia and 53 leucopenia. Hb levels increased significantly from 9.9±0.6 g/dL to 11.7±1.4 g/dL at month 48 (p<0.001). Platelet counts rose from 110.2±38.1×10⁹/L to 176.6±88.7×10⁹/L (p=0.004), Lym counts from 0.72±0.21×10⁹/L to 1.14±0.45×10⁹/L (p<0.001) and leucocyte counts from 2.437±0.533×10⁹/L to 4.732±1.897×10⁹/L at 48 months (p<0.001). Improvement in Hb (p=0.97), Plts (p=0.12), Lym (p=0.86) and Leuc (p=0.73) was similar regardless of the use of concomitant immunosuppressants. Glucocorticoid (GC) doses decreased significantly across all manifestations, except for leucopenia: anaemia (12.9±12.1 to 3.6±4.9 mg/day, p=0.003), thrombocytopenia (10.8±9.6 to 4.4±5.5 mg/day, p=0.004), lymphopenia (10.6±8.6 to 3.1±3.2 mg/day, p<0.001). Proportion of GC users declined over 48 months: anaemia 96.1-60.7%, thrombocytopenia 93.1-80%, lymphopenia 96.3-70.3% and leucopenia 95.3-80%.</p><p><strong>Conclusion: </strong>In this real-world cohort, BEL treatment was associated with improvement in anaemia, thrombocytopenia, lymphopenia and leucopenia with over half of patients achieving normalisation of blood counts. Haematological responses were similar regardless of concomitant immunosuppressive therapy, supporting the role of BEL as a therapeutic option for haematological abnormalities in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839763","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":"Evaluation of clinical, histological and biomarker response after initial therapy of lupus nephritis.","authors":"Danielle Christinne Egypto, Edgard Torres Dos Reis-Neto, Guilherme Pereira Carlesso, Luiz Antonio Moura, Luis E C Andrade, Debora Calderaro, Emilia Inoue Sato","doi":"10.1136/lupus-2025-001709","DOIUrl":"10.1136/lupus-2025-001709","url":null,"abstract":"<p><strong>Primary objective: </strong>To evaluate histopathological renal response in re-biopsy after induction therapy and to correlate with the Target Renal Response (TRR) and secondary objective: to correlate serum and urinary biomarkers with creatinine, 24-hour proteinuria, histological class, activity index and chronicity index.</p><p><strong>Methods: </strong>Open, longitudinal, multicentre study in lupus nephritis (LN) confirmed through renal biopsy. Two kidney biopsies (T1 and T2) were performed. Laboratory evaluations included urinary sediment examination, renal function, 24-hour proteinuria, serum C3/C4, anti-dsDNA, antinucleosome, anticardiolipin immunoglobulin M/immunoglobulin G, other serum (anti-C1q, monocyte chemoattractant protein 1 (MCP-1), lipocalin-associated neutrophil gelatinase (NGAL) and kidney injury molecule 1 (KIM-1)) and urinary biomarkers (tumour necrosis factor-related weak inducer of apoptosis (TWEAK), anti-interleukin 16, activated leucocyte cell adhesion molecule, MCP-1, NGAL, KIM-1, adiponectin, haemopexin and ceruloplasmin).</p><p><strong>Results: </strong>24 patients (mean age 32.5±8.2 years) were studied. After induction therapy, 18 patients achieved TRR. Among six patients who did not reach TRR, three failed to meet the 24-hour proteinuria criterion, two to the creatinine criteria and one to both criteria. Histological response was achieved by 14 patients; among these, four patients did not reach the TRR. We found 12 discordances between clinical and histological responses. Eight patients achieved TRR without histological response and four patients achieved histological response without TRR. Serum NGAL and serum KIM-1 showed correlation with urea and with creatinine and higher levels of urinary TWEAK were found in patients who remained with abnormal haematuria at T2. However, no correlation of these new biomarkers was found with activity score or histological class in this study.</p><p><strong>Conclusion: </strong>Discordance between clinical and histological response was confirmed, more patients achieved clinical response than histological response and, even in patients with histological response, not everyone presented clinical response. In a short interval of time, we observed early reduction in proteinuria and change in histological class after induction therapy. The lack of correlation between biomarkers and baseline histological parameters, which is inconsistent with prior studies, renders the biomarker findings inconclusive.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775629","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":"Systematic review of culture-confirmed septic pericarditis in systemic lupus erythematosus with an index case.","authors":"Laith Alamlih, Hind Neiroukh, Noran Qawasmeh, Mohammad A Rayyan, Haitham Alamlih, Kataeb Doudin, Taimaa Amro, Jamal Abumounshar, Heba Henahen","doi":"10.1136/lupus-2026-002004","DOIUrl":"10.1136/lupus-2026-002004","url":null,"abstract":"<p><strong>Objective: </strong>Pericardial involvement is common in systemic lupus erythematosus (SLE), but distinguishing sterile immune-mediated pericarditis from septic pericarditis is difficult because clinical features overlap with sepsis, immunosuppressive effects and nonspecific serologic abnormalities. Septic pericarditis in SLE is rare yet potentially fatal and existing evidence is limited to isolated case reports.</p><p><strong>Case presentation: </strong>We describe a fatal case of a patient in the fourth decade of life with newly diagnosed SLE who developed methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) purulent pericarditis. Despite broad-spectrum antibiotics and immunosuppressive therapy for multisystem lupus activity, the patient deteriorated rapidly due to MRSA-positive pericarditis.</p><p><strong>Methods: </strong>In parallel with this index case, we systematically searched PubMed/MEDLINE, Google Scholar and ResearchGate for case reports and series of microbiologically confirmed septic or purulent pericarditis in SLE, from inception to March 2025 and updated through November 2025. Two reviewers independently screened studies; extracted relevant clinical, microbiologic, immunologic and outcome data; and synthesised findings descriptively.</p><p><strong>Results: </strong>Fifteen published culture-confirmed cases plus our index case were identified (total n=16). Most patients were female (93.8%), with a mean age of 34.1 years. <i>Staphylococcus aureus</i> (including MRSA) and <i>Salmonella</i> species predominated. Dyspnoea (68.8%) was more frequent than fever (31.3%) and nearly all patients progressed to cardiac tamponade requiring urgent drainage. Survival was 93.8% when timely pericardial drainage and pathogen-directed antimicrobial therapy were achieved, while routine serological markers failed to distinguish infection from lupus flare.</p><p><strong>Conclusions: </strong>Septic pericarditis in SLE is uncommon but rapidly progressive. Early echocardiography and a low threshold for diagnostic pericardiocentesis are essential to prevent fatal delay.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775642","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":"Forgotten costs of systemic lupus erythematosus: estimating indirect healthcare costs in a national prospective observational Canadian lupus cohort.","authors":"Megan R W Barber, Yvan St Pierre, Christine A Peschken, Alexandra Legge, John G Hanly, Evelyne Vinet, Christian A Pineau, Sasha Bernatsky, Zahi Touma, Murray B Urowitz, Dafna D Gladman, Paul R Fortin, Ann E Clarke","doi":"10.1136/lupus-2025-001851","DOIUrl":"10.1136/lupus-2025-001851","url":null,"abstract":"<p><strong>Objectives: </strong>To assess indirect costs (IDC) due to lost productivity in paid/unpaid labour, stratified by sex, in a national prospective observational multicentre Canadian SLE cohort.</p><p><strong>Methods: </strong>Patients from six centres reported on lost productivity in paid/unpaid labour. IDC included: absenteeism (time lost from paid labour because of illness), presenteeism (degree of productivity impairment in paid/unpaid labour) and opportunity costs (additional time patients would be working in paid/unpaid labour if not ill). Opportunity costs were the difference between the time patients reported working and the time worked by an age, sex and geography-matched general population. IDC were valued using Statistics Canada wages (2024 Canadian dollars) with unpaid labour calculated using the opportunity cost method (OCM) and replacement cost method (RCM). The association of sex with IDC components was assessed (adjusted for race/ethnicity, age, disease duration, education and the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index) using regression modelling.</p><p><strong>Results: </strong>Of the 2180 patients who participated, 90.5% were female and 67.1% were white; the mean age at diagnosis was 33.2 years and mean SLE duration was 14.7 years. Patients completed an average of 3.4 questionnaires with 51.2% of women and 47.1% of men employed at baseline. Total annual IDC were significantly higher among women using the OCM (women $35 330; men $32 016) and did not differ using the RCM (women $26 114; men $26 136). Regressions showed total IDC did not differ using either method. Unpaid labour costs were significantly higher among women (OCM: women $22 680; men $11 591 and RCM: women $13 465; men $5711) and paid labour costs were significantly higher among men (women $12 651; men $20 425). Regressions showed similar results.</p><p><strong>Conclusion: </strong>IDC in SLE, particularly resulting from unpaid labour, are substantial, especially in women, where they represent up to 64.2% of total IDC versus 36.2% in men. Hence, economic analyses of novel/emerging therapies should incorporate lost productivity, including unpaid labour costs, which are of particular importance in diseases disproportionately affecting women.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775608","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":"Validity and applicability of machine learning models for systemic lupus erythematosus diagnosis.","authors":"Rui-Cen Li, An-Fang Huang, Lin-Chong Su, Da-Cheng Wang, Wang-Dong Xu","doi":"10.1136/lupus-2026-002007","DOIUrl":"10.1136/lupus-2026-002007","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of systemic lupus erythematosus (SLE) is clinically complex, and early identification is essential for timely intervention and reducing disease burden. Machine learning offers a promising approach to distinguish early-stage SLE patients from healthy individuals.</p><p><strong>Methods: </strong>A total of 2672 SLE patients and 154 798 healthy controls from the Luzhou (discovery) cohort, along with 2532 SLE patients and 38 597 healthy controls from the Enshi (validation) cohort, were enrolled in this study. A complete machine learning pipeline-including data preprocessing, feature selection, model training and postanalysis, was developed in the Luzhou cohort and subsequently validated in the Enshi cohort. Optimal features and the best-performing model were identified in the Luzhou cohort, then scaled and validated in the Enshi cohort. Model performance was evaluated using 13 binary classification metrics. The optimal feature set and model were integrated to construct an Artificial Intelligence Prediction tool for SLE (AI-PSLE).</p><p><strong>Results: </strong>Fifty candidate features were initially selected in the Luzhou cohort, among which the light gradient boosting (LGB) model demonstrated the best performance following data preprocessing. After scaling in the Enshi cohort, 35 reproducible features were retained. The LGB model based on these 35 features maintained superior performance in the Luzhou cohort and was further successfully validated in both the Enshi and combined Luzhou+Enshi cohorts.</p><p><strong>Conclusions: </strong>We developed an open-access, clinically user-friendly tool-AI-PSLE-based on 35 routine features, aimed at facilitating the early identification of SLE patients from healthy populations.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775648","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}