Lupus Science & Medicine最新文献

{"title":"Prevalence of falls in a pooled US cohort of adults with systemic lupus erythematosus: a nested cross-sectional study.","authors":"Laura C Plantinga, Jessica Fitzpatrick, S Sam Lim, Maria Dall'Era, Charmayne Marie Dunlop-Thomas, Courtney Hoge, Patricia P Katz, Jinoos Yazdany, C Barrett Bowling","doi":"10.1136/lupus-2026-002156","DOIUrl":"10.1136/lupus-2026-002156","url":null,"abstract":"<p><strong>Objective: </strong>Epidemiologic data on falls in the population with systemic lupus erythematosus (SLE) remain sparse. We estimated the prevalence and correlates of falls among adults with SLE and compared SLE prevalence estimates with those in the general US population.</p><p><strong>Methods: </strong>We assessed falls in a nested cross-sectional study within two pooled population-based SLE cohorts in California (3/2025-2/2026) and Georgia (10/2019-5/2022). Stratified prevalence was assessed with marginal estimates from logistic regression models with falls as the outcome. Age-standardised and sex-standardised estimates in SLE were compared with 2023 US population estimates (ages ≥45 only).</p><p><strong>Results: </strong>In this pooled SLE cohort (N=780; mean age, 47.9; 91.9% women; 14.5% Asian, 51.7% black, 13.2% Hispanic), 26.0% reported any fall in the prior year; among these, 59.1% reported falling two times or more and 31.0% reported associated injuries. General factors (oldest vs youngest age (37.4% vs 20.7% for ≥65 vs 20-44)) and SLE-related factors (higher SLE activity (38.5% vs 13.5%), moderate-to-severe depressive symptoms (40.0% vs 23.7%), greater pain interference (43.8% vs 16.5%), greater fatigue (39.2% vs 18.8%) and lower cognitive function (39.7% vs 18.9%)) were statistically significantly associated with higher fall prevalence in the SLE cohort. Among those aged ≥45, the age-standardised and sex-standardised prevalence estimate in the SLE population (22.9%) was similar to the US population estimate (19.5%).</p><p><strong>Conclusion: </strong>The prevalence of falls in SLE is high and recurrence is common, suggesting clinical assessment of falls-especially in those with high disease activity and symptoms-is important in SLE.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794544","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":"Maternal systemic autoimmune rheumatic diseases and childhood mental disorders: a nationwide cohort study.","authors":"Ya-Chun Huang, Ya-Hui Hu, Chung-Yi Li, Zeyan Liew, Meng-Yu Weng, Julia E Heck, Pei-Chen Lee","doi":"10.1136/lupus-2026-002129","DOIUrl":"10.1136/lupus-2026-002129","url":null,"abstract":"<p><strong>Objective: </strong>Prior studies suggested that maternal systemic autoimmune rheumatic diseases (SARDs) may increase the risk of mental disorders (MDs) in offspring. However, evidence is limited by heterogeneous definitions of autoimmune rheumatic diseases, focusing on specific MDs and scarce data from Asian populations. We aimed to investigate the association between maternal SARDs and the risk of childhood MDs.</p><p><strong>Methods: </strong>Our study included 1 949 968 maternal-child dyads identified in the Taiwan Maternal and Child Health Database between 2004 and 2015. Maternal SARD diagnoses were identified based on approved catastrophic illness certificates, while childhood MDs were identified by documentation of a relevant diagnostic code in the nationwide health insurance claims data. Cox proportional hazard models were used to examine the association between maternal SARDs and childhood MDs.</p><p><strong>Results: </strong>After a mean follow-up of 11.7 years, there were 774 (19.8%) and 306 907 (15.8%) live births born to mothers with and without SARDs respectively, which developed childhood MDs. Maternal SARDs were associated with an increased risk of childhood MDs (HR, 1.30; 95% CI 1.19 to 1.41). Elevated risks of childhood MDs were observed among offspring of mothers with systemic lupus erythematosus (HR=1.26, 95% CI 1.13 to 1.41), primary Sjogren's syndrome (HR=1.59, 95% CI 1.29 to 1.97), idiopathic inflammatory myositis (HR=1.73, 95% CI 1.06 to 2.83) and systemic sclerosis (HR=1.94, 95% CI 1.15 to 3.28), compared with mothers without SARDs.</p><p><strong>Conclusion: </strong>In this nationwide, population-based study from an Asian population, maternal SARDs were associated with higher risks of childhood MDs. Our findings suggest early monitoring of MDs among offspring of mothers with SARDs as part of clinical practice.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764421","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":"The lupus damage index revision program: Results from the item generation and reduction phases.","authors":"Burak Kundakci, Megan R W Barber, Ann E Clarke, Sindhu R Johnson, Anselm Mak, Hermine I Brunner, Murat Inanc, Rosalind Ramsey-Goldman, Guillermo Ruiz-Irastorza, Ellen M Ginzler, John G Hanly, Alexandra Legge, Cynthia Aranow, Laurent Arnaud, Nathalie Costedoat-Chalumeau, Dafna D Gladman, Søren Jacobsen, Michelle A Petri, Clovis A Silva, Evelyne Vinet, Alexandre E Voskuyl, Ian N Bruce","doi":"10.1136/lupus-2026-002282","DOIUrl":"10.1136/lupus-2026-002282","url":null,"abstract":"<p><strong>Objective: </strong>A data-driven and expert/patient consensus-based project to develop a revised Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI) is under way supported by SLICC, ACR, and the Lupus Foundation of America. Our objective is to report the item generation and reduction phase results for a revised SDI.</p><p><strong>Methods: </strong>Item generation included a literature review by literature review groups and a Delphi exercise of international systemic lupus erythematosus experts and patients. Item reduction involved Delphi rounds in which items with a median appropriateness score of ≤ 4 of 9 were excluded. A 14-member item reduction committee assessed remaining items and removed those that did not reflect the damage construct, were rare, or were not feasible to assess. The clinical domain groups then refined the remaining items and their definitions.</p><p><strong>Results: </strong>The Delphi panel included 146 individuals from 35 countries. The Delphi exercise nominated 2256 items, and the literature review identified 117 items. After removing redundancies, 226 candidate items remained. Subsequent Delphi rounds, followed by review by the item reduction committee and clinical domain groups, resulted in 39 items across 13 domains. Eleven items from the original SDI, including proteinuria and cranial neuropathy, were removed and several new items were proposed, including growth failure/reduced final height and adrenal insufficiency. Severity-based subitems are proposed for 17 items (43.6%).</p><p><strong>Conclusion: </strong>This data-driven and expert/patient consensus-based process has proposed 39 candidate items, some with subitems, and definitions for a revised SDI. Weighting of items and subitems is underway to develop a clinical scoring system.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723578","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":"Free mycophenolic acid exposure for therapeutic drug monitoring in paediatric lupus nephritis: associations with treatment response and haematologic toxicity.","authors":"Xuerui Tong, Jingxuan Lin, Lizhi Chen, Yutong Guo, Baojing Liu, Min Huang, Kejing Tang, Pan Chen, Xiaoyun Jiang","doi":"10.1136/lupus-2026-002091","DOIUrl":"10.1136/lupus-2026-002091","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the associations of free mycophenolic acid (f-MPA) concentration and total MPA (t-MPA) concentration with treatment response and haematologic toxicity and to determine whether f-MPA provides additional safety-related value for therapeutic drug monitoring (TDM) in patients with paediatric lupus nephritis (LN) treated with mycophenolate mofetil (MMF).</p><p><strong>Methods: </strong>Sixty-five patients with paediatric LN receiving MMF were prospectively enrolled. The t-MPA and f-MPA were measured simultaneously using validated ultrafiltration and LC-MS/MS. Full pharmacokinetic profiles were obtained over 12 hours, and area under the concentration-time curve (AUC) was calculated for t-MPA (t-MPA-AUC) and f-MPA (f-MPA-AUC). Univariate analysis identified factors influencing efficacy (relapse-free survival) and adverse drug reaction (ADR) over 12 months. Receiver operating characteristic (ROC) curves established predictive thresholds and Kaplan-Meier methods analysed time-to-event.</p><p><strong>Results: </strong>The 12-month relapse-free rate was 78.7% (95% CI 66.6% to 90.9%). Both t-MPA-AUC and f-MPA-AUC significantly correlated with relapse-free survival (ROC AUC 0.70 each; optimal thresholds: t-MPA-AUC=31.63 µg·h/mL, f-MPA-AUC=354.45 ng·h/mL). The average remission duration above these thresholds was 10.88 and 11.00 months. The overall MMF-related ADR incidence was 25.2%, including 17 haematological events (26.2%). The t-MPA-AUC, f-MPA-AUC, glucose, β2-microglobulin and C3 were haematological ADR risk factors. The f-MPA-AUC independently predicted haematological ADRs (optimal threshold: 492.96 ng·h/mL; specificity 86.2%).</p><p><strong>Conclusion: </strong>Both t-MPA-AUC and f-MPA-AUC effectively predict MMF efficacy in paediatric LN. However, f-MPA-AUC demonstrates superior predictive value for safety outcomes, specifically haematological ADRs. This supports f-MPA as a potentially better TDM metric for optimising MMF therapy safety in this population.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713042","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":"Immune thrombocytopenia is rare in patients with antiphospholipid syndrome without systemic lupus erythematosus: insights from a series of 351 patients.","authors":"Boris Sorin, Nathalie Morel, Yann Nguyen, Ada Clarke, Romain Stammler, Véronique Le Guern, Nathalie Costedoat-Chalumeau","doi":"10.1136/lupus-2026-002084","DOIUrl":"10.1136/lupus-2026-002084","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the aetiologies of thrombocytopenia in patients with antiphospholipid syndrome (APS) and to assess the frequency and characteristics of immune thrombocytopenia (ITP), including its association with SLE.</p><p><strong>Methods: </strong>We retrospectively analysed patients with APS who experienced at least one episode of thrombocytopenia (platelet count <100 x 10ˆ9/L) in a tertiary referral cohort enriched in severe cases, particularly catastrophic antiphospholipid syndrome (CAPS). Individual medical records were systematically reviewed to determine the cause of thrombocytopenia. ITP was stringently defined by exclusion of alternative diagnoses and by a documented response to ITP-specific therapies. Clinical, biological and therapeutic characteristics were analysed. The risk of severe haemorrhagic events was evaluated.</p><p><strong>Results: </strong>Among 351 patients with APS, 102 (29.1%) experienced thrombocytopenia and were included in the study. The median platelet nadir was 34.5 x 10ˆ9/L, and 33 (32.4%) had severe thrombocytopenia (<20 x 10ˆ9/L). The most frequent cause of thrombocytopenia was CAPS (n=75, 73.5%), followed by ITP (n=12, 11.8%), including two patients who had both CAPS and ITP. 11 (10.8%) patients had other identified causes, while thrombocytopenia remained unexplained in six patients (5.9%).Patients with ITP more frequently had associated SLE than those with CAPS (80.0% vs 35.6%, p=0.013). Overall, isolated ITP without SLE accounted for only 0.6% of the entire APS cohort. In survival analysis, a graded increase in the risk of severe haemorrhagic events was observed with increasing thrombocytopenia severity, although the association did not reach statistical significance (HR 2.55, 95% CI 0.94 to 6.94 for platelet nadir <20 x 10ˆ9/L vs >100 x 10ˆ9/L).</p><p><strong>Conclusion: </strong>In patients with APS, the underlying cause of thrombocytopenia can be identified in most cases through careful review of medical records. True ITP is uncommon and appears to be exceptionally rare in patients with APS without concomitant SLE. These findings highlight the importance of thoroughly investigating alternative causes of thrombocytopenia and of systematically screening for SLE before diagnosing ITP in patients with APS.</p><p><strong>Trial registration number: </strong>NCT02782039.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713018","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":"CD163: a potential biomarker for lupus nephritis activity.","authors":"Erdem Gürel, Suzan Çinar, Özge Hürdogan, Yasemin Özlük, Gamze Kemeç, Ömer Uludağ, Sibel Varelci, Safak Mirioğlu, Yasemin Yalçinkaya, Ahmet Gül, Murat Inanç, Bahar Artim-Esen","doi":"10.1136/lupus-2026-002166","DOIUrl":"10.1136/lupus-2026-002166","url":null,"abstract":"<p><strong>Objectives: </strong>CD163 is a macrophage-associated scavenger receptor shed during inflammatory activation, resulting in measurable soluble CD163 in serum (s) and urine (u). Elevated levels have been reported in inflammatory and immune-mediated conditions, including lupus nephritis (LN). This study aimed to investigate the relationship between soluble CD163 levels and intrarenal CD163 expression, evaluating their association with disease activity and treatment response in LN.</p><p><strong>Methods: </strong>Forty-five patients with systemic lupus erythematosus (SLE) were included (20 active LN, 10 inactive LN, 15 active extra-renal SLE), together with 20 matched healthy controls. Serum and urine samples were collected at baseline alongside renal biopsy in active LN; 6-month follow-up samples were available for 12 active LN patients. CD163 was measured by ELISA; urinary CD163 was normalised to spot urine creatinine. Renal biopsies from 20 active LN patients were evaluated for CD163+ macrophage density.</p><p><strong>Results: </strong>uCD163 was higher in active LN (a renal Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) flare (UPCR ≥0.5 g/g) with biopsy-proven active lesions) than in inactive LN and active extra-renal SLE (both p<0.001), discriminating active from inactive LN (area under the curve (AUC) 0.97) and from extra-renal SLE (AUC 0.89). uCD163 correlated with the National Institutes of Health activity and chronicity indices activity index (ρ=0.55, p=0.016) and with glomerular CD163+ macrophage density (the number of CD163+ macrophages per glomerulus quantified by immunohistochemistry; ρ=0.65, p=0.006), but not with chronicity. Glomerular CD163+ macrophage density also correlated with sCD163 (ρ=0.60, p=0.01) and uCD163 (ρ=0.63, p=0.009). After 6-month induction, uCD163 fell from 7.41 to 1.55 ng/mg (p<0.001).</p><p><strong>Conclusion: </strong>uCD163 distinguishes active LN from inactive renal and extra-renal disease and tracks treatment response. The association with intrarenal CD163+ macrophages supports its biological relevance as a non-invasive marker of renal inflammation, complementary to histopathology when repeat biopsy is not feasible. These findings support uCD163 as a candidate non-invasive tool for identifying active LN and monitoring treatment response in SLE, warranting validation in larger prospective cohorts.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707075","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":"Diagnostic value of cerebrospinal fluid antisuprabasin antibody in neuropsychiatric systemic lupus erythematosus.","authors":"Fan Zhang, Feng Zhao, Chenyu Fan, Chao Tang, Jun Ma, Jie Yu, Xiaodong Wang, Wanlong Wu, Yi Chen, Shuangjun He","doi":"10.1136/lupus-2026-002144","DOIUrl":"10.1136/lupus-2026-002144","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic attribution of neuropsychiatric symptoms in SLE (NPSLE) remains challenging. This study evaluated whether cerebrospinal fluid (CSF) antisuprabasin (SBSN) antibody can serve as a diagnostic biomarker for NPSLE.</p><p><strong>Methods: </strong>In this single-centre, prospective cohort study, patients with SLE presenting with new-onset neuropsychiatric or neurological symptoms were screened between January 2022 and October 2025. Final diagnoses were adjudicated by an independent committee blinded to CSF anti-SBSN antibody results. Patients were classified as NPSLE, SLE with central nervous system infection (SLE-CNSI) or SLE without NPSLE or CNS infection (SLE-Other). CSF anti-SBSN antibody levels were measured by ELISA. Diagnostic performance was assessed for identifying NPSLE against a combined non-NPSLE comparator group comprising SLE-CNSI and SLE-Other.</p><p><strong>Results: </strong>Among 190 screened patients, 148 were included in the final analysis, including 48 with NPSLE, 59 with SLE-CNSI and 41 with SLE-Other. CSF anti-SBSN antibody levels showed a stepwise increase across groups, with median concentrations of 47.60 ng/mL in SLE-Other, 72.82 ng/mL in SLE-CNSI and 88.94 ng/mL in NPSLE; all pairwise comparisons were significant (all p<0.001). For identifying NPSLE versus non-NPSLE comparators, CSF anti-SBSN antibody achieved an area under the receiver operating characteristic curve (AUROC) of 0.830, with a sensitivity of 0.812 and specificity of 0.740 at the optimal cut-off of 76.36 ng/mL. CSF anti-SBSN antibody had a higher AUROC than CSF white blood cell count (0.830 vs 0.743; p=0.041) and serum antiribosomal P antibody (0.830 vs 0.665; p=0.003). The three-marker model further increased the AUROC to 0.892 and significantly outperformed CSF anti-SBSN antibody alone (p=0.009).</p><p><strong>Conclusion: </strong>CSF anti-SBSN antibody was significantly elevated in NPSLE and demonstrated good diagnostic performance for identifying NPSLE among patients with SLE presenting with neuropsychiatric symptoms. These findings support CSF anti-SBSN as a promising candidate diagnostic biomarker for NPSLE, particularly when combined with conventional CSF inflammatory and serological markers.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684969","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":"Occurrence of venous thromboembolism in SLE: findings from a nationwide cohort and a clinical cohort in Sweden.","authors":"Tamara Vojinovic, Natali Karandyszowska, Iva Gunnarsson, Elisabet Svenungsson, Aleksandra Antovic, Elizabeth V Arkema","doi":"10.1136/lupus-2026-002058","DOIUrl":"10.1136/lupus-2026-002058","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the risk of venous thromboembolism (VTE) in a nationwide cohort of newly diagnosed patients with SLE and in a cohort of established patients with SLE at Karolinska University Hospital compared with the general population.</p><p><strong>Methods: </strong>Individuals with SLE were identified from the National Patient Register and matched to general population comparators on age, sex and residence. Follow-up was from diagnosis/matching until incident VTE, death, emigration or study end. The Karolinska cohort was followed from enrolment and additionally stratified by lupus nephritis (LN) and antiphospholipid antibody (aPL) positivity. Incidence rates (IR) of VTE were estimated and adjusted HRs with 95% CIs were estimated using Cox models. Time-dependent adjusted HRs were estimated using flexible parametric survival models.</p><p><strong>Results: </strong>In the nationwide cohort (N=4335), the mean age at inclusion was 49 years, 83% were female and mean follow-up was 7.4 years. The VTE IR was 8.8 per 1000 person-years compared with 2.8 in comparators, corresponding to an HR of 3.3 (95% CI 2.9 to 3.8). In the Karolinska cohort (N=784), the HR was 4.9 (95% CI 3.7 to 6.5). VTE risk was highest in the first few years after SLE diagnosis. LN was not significantly associated with VTE, and aPL positivity was associated with a 60% higher hazard, which was non-significant and attenuated after excluding individuals with prior VTE.</p><p><strong>Conclusion: </strong>SLE is associated with an over threefold increased risk of VTE, in particular soon after SLE diagnosis, underscoring the need for individualised VTE risk assessment.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684959","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":"High disease activity persists in adults with childhood-onset lupus.","authors":"Rachel Koelmeyer, Kate Gregory, Rangi Kandane-Rathnayake, Fiona Goldblatt, Sean O'Neill, Maureen Rischmueller, Mandana Nikpour, Geraldine Hassett, Pravin Hissaria, Dwarakanathan Ranganathan, Claire Barrett, Ashleigh Hennessey, Ted Tsai, Peter Gowdie, Eric F Morand, Alberta Hoi","doi":"10.1136/lupus-2026-002138","DOIUrl":"10.1136/lupus-2026-002138","url":null,"abstract":"<p><strong>Objective: </strong>Childhood-onset SLE (cSLE) is often described as more severe than adult-onset disease (aSLE) based largely on cross-sectional studies. We examined differences in disease characteristics, medication use and long-term outcomes between cSLE and patients with aSLE in adulthood using longitudinal data from a national cohort to address this knowledge gap.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the Australian Lupus Registry and Biobank. Data included demographics, disease duration, autoantibody profile, classification criteria, time-adjusted mean SLE Disease Activity Index 2000 (SLEDAI-2K AMS), SLE Damage Index (SDI) and SF36 health-related quality of life data. Key outcomes were AMS and time in the Lupus Low Disease Activity State (LLDAS) and damage accrual. Bivariate tests were used for group comparisons.</p><p><strong>Results: </strong>Of 519 patients with SLE enrolled between 2011 and 2022 with ≥12 months of data available, 68 (13%) had cSLE. Median (IQR) age at enrolment was 39 (30-51) years; 88.1% female; majority were of white or Asian ethnicity. At baseline, more patients with cSLE had damage (SDI≥1) (53% vs 40%, p=0·05) and renal involvement (62% vs 37%, p<0·001). Over median (IQR) follow-up of 5 (2·6-9·3) years, patients with cSLE had higher disease activity (median (IQR) AMS 5·0 (3·0-6·4) cSLE vs 3·6 (1·9-5·1) aSLE, p<0.001), were more likely to be in High Disease Activity Status (SLEDAI-2K ≥10 ever) and were less likely to achieve LLDAS-50 (36% vs 51%, p=0·036). Flare rates, damage accrual and quality of life during follow-up were similar between groups.</p><p><strong>Conclusions: </strong>Adults with cSLE entered adult follow-up with higher baseline damage and continued to experience a higher longitudinal disease activity burden than patients with aSLE. These findings highlight the importance of early recognition, consistent longitudinal monitoring and timely escalation of therapy during earlier years of disease to reduce long-term disease burden.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679201","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":"Peripheral blood CD19+B cell proportion at baseline predicts early complete response to belimumab treatment in patients with refractory lupus nephritis.","authors":"Xinxin Xie, Yan Zhou, Quangang Zhu, Yun Liao, Zhongjian Chen, Weihua Song","doi":"10.1136/lupus-2026-002100","DOIUrl":"10.1136/lupus-2026-002100","url":null,"abstract":"<p><strong>Objective: </strong>Belimumab has been proven to be effective for treating refractory lupus nephritis. However, the meaningful renal response is still far from satisfactory. This study sought to identify immunological biomarkers to stratify patients who are likely to benefit from belimumab therapy.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients with refractory lupus nephritis who received 6 months belimumab treatment. Complete response (CR), partial response (PR) and no response (NR) were evaluated, and the predictors of CR were identified.</p><p><strong>Results: </strong>A total of 28 patients with refractory LN were enrolled. The proportions of CR, PR and NR at 6 months were 39.29%, 32.14% and 28.57%, respectively. The baseline CD19+B cell proportions were significantly higher in CR patients than those in non-CR patients (19.30% vs 10.72%, p<0.001). In the binary logistic regression, baseline CD19+B cell proportion was identified as a predictor of CR in both univariate analysis (OR 1.359, 95% CI 1.098 to 1.683, p=0.005) and exploratory multivariate analysis adjusting for 24-hour urinary protein (OR 1.349, 95% CI 1.092 to 1.665, p=0.005). Receiver operating characteristic showed that the cut-off level of CD19+B cell proportion was 15.12%, with a sensitivity of 90.90%, specificity of 88.20% and an area under curve of 0.888 (95% CI 0.759 to 1.000, p=0.001).</p><p><strong>Conclusion: </strong>Findings support the baseline CD19+B cell proportion could be used to predict CR to treatment with belimumab in refractory lupus nephritis patients.</p>","PeriodicalId":18126,"journal":{"name":"Lupus Science & Medicine","volume":"13 2","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669932","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}