Lupus Science & Medicine最新文献

{"title":"Meeting report: The Systemic Lupus International Collaborating Clinics (SLICC) World Lupus Seminar on Africa.","authors":"Alexandra Legge, John A Reynolds, Manuel Francisco Ugarte-Gil, Olufemi Adelowo, Ashira Blazer, Dzifa Dey, Eunice Omondi, Omondi Oyoo, Rosalind Ramsey-Goldman","doi":"10.1136/lupus-2024-001452","DOIUrl":"10.1136/lupus-2024-001452","url":null,"abstract":"<p><p>The Systemic Lupus International Collaborating Clinics (SLICC) is an international research group dedicated to promoting collaboration among scientific investigators in the study of systemic lupus erythematosus (SLE). Currently, most SLICC members are based in North America and Europe, with limited representation from other regions. SLICC recognises the importance of expanding its global collaborations and representation to ensure that its research accurately reflects the global burden of SLE and provides equal benefit to all patients with SLE worldwide. Given that SLICC currently lacks representation from the African continent, an opportunity was identified to convene a meeting bringing together lupus physicians with experience providing clinical care and conducting lupus research in Africa, along with members of the SLICC group. The purpose of the meeting was to share information regarding SLE in Africa, to discuss recent innovations and current challenges in the region and to explore future collaborations between SLICC members and colleagues in Africa in the areas of SLE clinical care, research and education. This meeting report highlights information presented during the seminar as well as a discussion of next steps moving forward.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542477","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":"Mortality patterns of SLE and the associated risk factors in Korean patients: a nationwide cohort study.","authors":"Soo-Kyung Cho, Yena Jeon, Jung-Hyo Kim, Eun Jin Jang, Sun-Young Jung, Yoon-Kyoung Sung","doi":"10.1136/lupus-2024-001361","DOIUrl":"10.1136/lupus-2024-001361","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the mortality patterns of SLE and the associated risk factors in Koreans.</p><p><strong>Methods: </strong>Using the National Health Insurance database spanning 2008 to 2018, incident cases of SLE in patients aged 10-79 years were included. We analysed the all-cause mortality and cause-specific mortality, stratifying by sex and age. The mortality rate (MR) was calculated as the number of deaths per 100 000 person-years (PYs). The causes of death were identified by the International Classification of Diseases, 10th Revision codes during hospitalisation or emergency visit prior to death. A generalised estimating equation model was employed for risk factor analysis.</p><p><strong>Results: </strong>In total, 11 375 incident SLE cases among patients with an average age of 42.3±16.7 years were recruited (86.1% female). During 57 658 PYs, 728 deaths occurred (MR 1262.62/100 000 PYs). The MR among men (2718.86/100 000 PYs) exceeded that among women (1060.57/100 000 PYs). The leading causes of death were SLE-related conditions (381.56/100 000 PYs), cardiovascular disease (CVD) (202.92/100 000 PYs), cancer (175.17/100 000 PYs) and infection (143.95/100 000 PYs). Of the SLE-related mortality, the key risk factors were pulmonary complications, such as pulmonary alveolar haemorrhage (OR 9.93), pulmonary arterial hypertension (OR 3.77) and interstitial lung disease (OR 3.27).</p><p><strong>Conclusions: </strong>Among Korean patients with SLE, SLE-related conditions were the leading causes of mortality. However, CVD and cancer were also identified as the main causes of mortality. Furthermore, pulmonary manifestations were significantly associated with SLE-related mortality.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515962","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":"Development and evaluation of a Register-Based Organ Damage Index in systemic lupus erythematosus: a nationwide, population-based study from Sweden.","authors":"Alvaro Gomez, Ioannis Parodis, Muna Saleh, Julia F Simard, Christopher Sjöwall, Elizabeth V Arkema","doi":"10.1136/lupus-2024-001403","DOIUrl":"10.1136/lupus-2024-001403","url":null,"abstract":"<p><strong>Objective: </strong>To develop a Register-Based Organ Damage Index (RBODI) in SLE, and evaluate its accuracy in estimating Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) scores. Additionally, to describe organ damage accrual and associations with mortality in a Swedish population-based nationwide cohort.</p><p><strong>Methods: </strong>SDI items were translated into diagnosis, treatment and procedural codes retrieved from Swedish health registers. RBODI was calculated using the same rules as the SDI and its accuracy was evaluated using SDI data from the <i>Clinical Lupus Register in North-Eastern Gothia</i> cohort as the gold standard. Among newly diagnosed patients with SLE from Sweden (2005-2021), we estimated 5-year risks of organ damage, and adjusted HRs of first RBODI-based organ damage accrual associated with patient characteristics. Lastly, we estimated the association between RBODI-based organ damage within 5 years of diagnosis and mortality.</p><p><strong>Results: </strong>The evaluation cohort included 271 prevalent cases (65.3% developed organ damage). RBODI had a positive predictive value of 90%, sensitivity 80% and specificity 83%. Among 4441 newly diagnosed patients with SLE, 40% developed organ damage within 5 years. Males had a 30% higher risk of developing damage compared with females (HR 1.3) and older individuals (>45 years old compared with younger) had more than threefold higher risk (HR 3.3). Early development of organ damage was associated with a 2.1-fold higher risk of mortality.</p><p><strong>Conclusion: </strong>Our novel RBODI accurately estimates SDI scores and describes long-term trends in damage accrual in the largest cohort of incident SLE to date. The strong association between early damage accrual and mortality highlights the need for efficient prevention strategies.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515958","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":"Hydroxychloroquine in patients with systemic lupus erythematosus: how much is enough?","authors":"Guillermo Ruiz-Irastorza, Diana Paredes-Ruiz, Fernando Arizpe, Valerio Campos-Rodriguez, Victor Moreno-Torres, Laura Amo, Ioana Ruiz-Arruza, Daniel Martin-Iglesias","doi":"10.1136/lupus-2024-001254","DOIUrl":"10.1136/lupus-2024-001254","url":null,"abstract":"<p><strong>Objective: </strong>To assess the daily and weight-adjusted dosages of hydroxychloroquine (HCQ) and the effects on long-term remission in the Lupus-Cruces cohort.</p><p><strong>Methods: </strong>Observational study of routine clinical care data. We selected inception patients treated with HCQ with at least 5 years of follow-up. Prolonged remission was achieved when patients fulfilled definitions of remission in systemic lupus erythematosus remission criteria in five consecutive yearly visits. The associations between the weight-adjusted dose of HCQ during 5 years and prolonged remission were analysed. We also investigated the associations between prednisone doses, immunosuppressives (IS) and other antimalarial use with HCQ doses.</p><p><strong>Results: </strong>150 inception patients fulfilled the inclusion criteria. The mean starting dose of HCQ was 206 mg/day. The mean weight-adjusted starting dose of HCQ was 3.1 mg/kg/day with no patients treated with doses ≥5 mg/kg/day. Treatment with HCQ was maintained during the whole 5-year follow-up time in 147 patients (98%). The mean dose of HCQ during the 5-year follow-up was 194.6 mg/day (2.9 mg/kg/day). 108 patients (72%) were in prolonged remission. The mean weight-adjusted dose of HCQ per patient did not differ between those who did and did not achieve prolonged remission (2.9 vs 3 mg/kg/day, p=0.5). The dose of prednisone per patient (mean 2.3 mg/day during the 5-year follow-up) did not differ according to the weight-adjusted dose of HCQ. The mean weight-adjusted HCQ dose during the whole follow-up was the same in patients treated or not with IS or with mepacrine.</p><p><strong>Conclusions: </strong>With the use of HCQ at stable doses of 200 mg/day (or 3.0-3.5 mg/kg/day) as the background therapy in patients with systemic lupus erythematosus, the majority of patients achieved prolonged remission.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515959","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":"Autoimmune encephalitis associated with anti-LGI1 antibody: a potential cause of neuropsychiatric systemic lupus erythematosus.","authors":"Sixian Chen, Haitao Ren, Siyuan Fan, Shangzhu Zhang, Mengtao Li, Hongzhi Guan","doi":"10.1136/lupus-2024-001429","DOIUrl":"10.1136/lupus-2024-001429","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical features and treatment outcomes of anti-leucine-rich glioma-inactivated 1 (anti-LGI1) encephalitis in patients with SLE.</p><p><strong>Methods: </strong>Between October 2014 and April 2024, serum or cerebrospinal fluid samples were collected from 332 patients with SLE suspected of autoimmune encephalitis. Cell-based assays were used to detect autoimmune antibodies, including anti-LGI1 antibodies. Four patients tested positive for anti-LGI1 antibodies, and their clinical, radiological and treatment data were analysed.</p><p><strong>Results: </strong>All four patients exhibited signs of limbic encephalitis, including short-term memory deficits, seizures and psychiatric disturbances. Two cases also presented with faciobrachial dystonic seizures. MRI findings revealed hyperintense basal ganglia lesions in two patients. Treatment with corticosteroids, intravenous immunoglobulin and mycophenolate mofetil led to significant improvement in three patients, with no relapses during a follow-up period ranging from 33 to 60 months. One patient succumbed to pneumonia despite initial improvement of neurological function.</p><p><strong>Conclusion: </strong>Screening for anti-LGI1 antibodies in patients with neuropsychiatric systemic lupus erythematosus (NPSLE) is crucial when limbic encephalitis presents, as it enables timely and effective treatment, potentially improving patients' outcomes. Additional basic and clinical research is required to clarify the pathogenic role of these antibodies in NPSLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449370","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":"Real-world oral glucocorticoid use in SLE: a nation-wide population-based study using the French medico-administrative (SNDS) claim database.","authors":"Laurent Arnaud, Caroline Fabry-Vendrand, Remus Todea, Blandine Vidal, Juliette Cottin, Isabelle Bureau, Stéphane Bouée, Gabriel Thabut","doi":"10.1136/lupus-2024-001428","DOIUrl":"10.1136/lupus-2024-001428","url":null,"abstract":"<p><strong>Background: </strong>Oral glucocorticoids (OCS) remain one of the most important treatments for SLE but are associated with damage. Evidence regarding the real-world use of OCS in nationwide SLE populations is currently lacking. The aim of this study was to analyse OCS use and SLE treatments in French patients with SLE at the national level.</p><p><strong>Methods: </strong>The nationwide French health insurance claims database, which contains pseudonymised data for ≈66 million people, was used. Prevalent patients with SLE (International Classification of Diseases, 10th Revision code M32, recorded as a chronic condition or associated with hospital stay) were identified over the year 2019. SLE treatments were captured through actual drug deliveries by pharmacies and mean daily OCS doses (prednisone equivalent) were calculated for the year 2019.</p><p><strong>Results: </strong>The 2019 French prevalent SLE population comprised 31 852 patients (86.3% of women, with a mean age of 49.7 (±15.9) years) with a mean disease duration of 7.1 (±6.2) years. Among these, 48.3% were treated with OCS. The mean daily OCS dose was ≤5 mg/day in 35.9%, more than 5 mg but <7.5 mg/day in 6.4% and ≥7.5 mg/day in 6.0%. The use of other SLE treatments was significantly increased in patients with higher doses of OCS (p<0.0001). Potential complications of OCS, including cardiovascular diseases, infections and osteoporosis, were significantly increased in patients with SLE receiving more than 5 mg of OCS per day (p<0.0001, for all). Strikingly, 13.6% of patients receiving mean daily OCS doses >5 mg/day were not treated with antimalarial, immunosuppressant or biologic drugs for SLE.</p><p><strong>Conclusions: </strong>In total, 48.2% of French patients with SLE were treated with OCS in 2019, including 12.4% at a mean dose >5 mg/day, with an increased risk of OCS complications and a limited use of antimalarials, immunosuppressants or biologics. These results highlight the urgent need for the implementation of more robust OCS-sparing strategies in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448282","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 primary aldosteronism testing in hypertensive patients with SLE in a tertiary hospital.","authors":"Matthew Wong, Alberta Y Hoi, Joanna R Kent, Peter J Fuller, Jun Yang, Fabien B Vincent","doi":"10.1136/lupus-2025-001524","DOIUrl":"10.1136/lupus-2025-001524","url":null,"abstract":"","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448314","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":"Identification and functional characterisation of a novel DNASE1L3 variant (c.572A>G, p.Asn191Ser) in three Emirati families with systemic lupus erythematosus and hypocomplementaemic urticarial vasculitis.","authors":"Najla Aljaberi, Anjali Bharathan, Remya Prajesh Gopal, Ekhlass Mohammed, Fatema Al Shibli, Mohammed Tabouni, Sara Alhmoudi, Praseetha Kizhakkedath, Ibrahim Baydoun, Mushal Allam, Noor Mustafa, Fatma Aljasmi, Afra Al Dhaheri, Hiba Alblooshi","doi":"10.1136/lupus-2024-001477","DOIUrl":"10.1136/lupus-2024-001477","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the functional impact of a novel <i>DNASE1L3</i> variant (c.572A>G, p.Asn191Ser) in three families with SLE and hypocomplementaemic urticarial vasculitis (HUV) from the United Arab Emirates.</p><p><strong>Methods: </strong>Whole-exome sequencing was performed on affected patients and findings were confirmed using Sanger sequencing in family members. DNASE1L3 protein expression, secretion and enzymatic activity were assessed in HEK293 cell lines. Plasma smear assay for neutrophil extracellular traps (NETs) was evaluated in patients, family members and healthy control.</p><p><strong>Results: </strong>A total of seven patients diagnosed with both SLE and HUV were identified from three unrelated families. All affected individuals were found to carry a homozygous c.572A>G, p.Asn191Ser (191S) variant in <i>DNASE1L3</i>. The variant 191S was shown to impact the secretion and activity of DNASE1L3. Patients homozygous for 191S variant had significantly higher burden (p=0.0409) of NET structure in comparison to heterozygous and healthy control.</p><p><strong>Conclusions: </strong>We functionally evaluated the effect of a novel <i>DNASE1L3</i> (c.572A>G, p.Asn191Ser) in familial SLE with a consistent pattern of HUV across seven patients. This variant resulted in impaired secretion and enzymatic activity of DNASE1L3 along with increased NETosis in patients with homozygous genotype.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414625","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":"Prediction of mortality risk in critically ill patients with systemic lupus erythematosus: a machine learning approach using the MIMIC-IV database.","authors":"Zhihan Chen, Yunfeng Dai, Yilin Chen, Han Chen, Huiping Wu, Li Zhang","doi":"10.1136/lupus-2024-001397","DOIUrl":"10.1136/lupus-2024-001397","url":null,"abstract":"<p><strong>Objective: </strong>Early prediction of long-term outcomes in patients with systemic lupus erythematosus (SLE) remains a great challenge in clinical practice. Our study aims to develop and validate predictive models for the mortality risk.</p><p><strong>Methods: </strong>This observational study identified patients with SLE requiring hospital admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database. We downloaded data from Fujian Provincial Hospital as an external validation set. Variable selection was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) regression. Then, we constructed two predictive models: a traditional nomogram based on logistic regression and a machine learning model employing a stacking ensemble approach. The predictive ability of the models was evaluated by the areas under the receiver operating characteristic curve (AUC) and the calibration curve.</p><p><strong>Results: </strong>A total of 395 patients and 100 patients were enrolled respectively from MIMIC-IV database and the validation cohort. The LASSO regression identified 18 significant variables. Both models demonstrated good discrimination, with AUCs above 0.8. The machine learning model outperformed the nomogram in terms of precision and specificity, highlighting its potential superiority in risk prediction. The SHapley additive explanations analysis further elucidated the contribution of each variable to the model's predictions, emphasising the importance of factors such as urine output, age, weight and alanine aminotransferase.</p><p><strong>Conclusions: </strong>The machine learning model provides a superior tool for predicting mortality risk in patients with SLE, offering a basis for clinical decision-making and potential improvements in patient outcomes.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414627","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":"Time trends of variability in disease activity in systemic lupus erythematosus.","authors":"Ning Li, Alberta Hoi, Shue-Fen Luo, Yeong-Jian Jan Wu, Worawit Louthrenoo, Vera Golder, Sargunan Sockalingam, Jiacai Cho, Aisha Lateef, Sean O'Neill, Chak Sing Lau, Laniyati Hamijoyo, Mandana Nikpour, Shereen Oon, Yanjie Hao, Madelynn Chan, Zhanguo Li, Sandra Navarra, Leonid Zamora, Yasuhiro Katsumata, Masayoshi Harigai, Fiona Goldblatt, Sang-Cheol Bae, Zhuoli Zhang, Tsutomu Takeuchi, Jun Kikuchi, Kristine Ng, Nicola Tugnet, Yoshiya Tanaka, Naoaki Ohkubo, Yi-Hsing Chen, B M D B Basnayake, Annie Law, Sunil Kumar, Cherica Tee, Michael Lucas Tee, Jiyoon Choi, Rangi Kandane-Rathnayake, Eric Morand","doi":"10.1136/lupus-2024-001335","DOIUrl":"10.1136/lupus-2024-001335","url":null,"abstract":"<p><strong>Objective: </strong>Disease activity both between and within patients with SLE is highly variable, yet factors driving this variability remain unclear. This study aimed to identify predictors of variability in SLE disease activity over time.</p><p><strong>Methods: </strong>We analysed data from 2930 patients with SLE across 13 countries, collected over 38 754 clinic visits between 2013 and 2020. Clinic visit records were converted to panel data with 1-year intervals. The time-adjusted mean disease activity, termed <i>AMS</i>, was calculated. The yearly change in [Formula: see text], denoted as [Formula: see text], was regressed onto [Formula: see text] and other potential predictors using random-effects models. Some variables were split into a person-mean component to assess between-patient differences and a demeaned component to assess within-patient variability.</p><p><strong>Results: </strong>Overall, variability in SLE disease activity exhibited stabilisation over time. A significant inverse relationship emerged between a patient's disease activity in a given year and variability in disease activity in the subsequent year: a 1-point increase in person-mean disease activity was associated with a 0.27-point decrease (95% CI -0.29 to -0.26, p<0.001) in subsequent variability. Additionally, a 1-point increase in within-patient disease activity variability was associated with a 0.56-point decrease (95% CI -0.57 to -0.55, p<0.001) in the subsequent year. Furthermore, each 1-point increase in the annual average time-adjusted mean Physician Global Assessment was associated with a 0.08-point decrease (90% CI -0.13 to -0.03, p=0.002) in disease activity variability for the following year. Prednisolone dose and the duration of activity in specific organ systems exhibited negative and positive associations, respectively, with disease activity variability in the subsequent year. Patients from less affluent countries displayed greater disease activity variability compared with those from wealthier nations.</p><p><strong>Conclusion: </strong>Disease activity tends to be less variable among patients with higher or more variable disease activity in the previous year. Within-patient variability in disease activity has a stronger impact on subsequent fluctuations than differences between individual patients.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"12 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408805","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}