ArticleArthritis & rheumatology (Hoboken, N.J.)2015
Serious infections among adult Medicaid beneficiaries with systemic lupus erythematosus and lupus nephritis.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 6 of them syntheses that pooled it.
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Who cites it
99 citing papers in PubMed, 6 syntheses or guidelines pooled it, 214 citations in OpenAlex.
- Risk factors for infections in systemic lupus erythematosus: a meta-analysis.Immunologic research · 2025Pooled it
- Prevalence, incidence, and risk factors for herpes zoster in systemic lupus erythematosus: a systematic review and meta-analysis.Frontiers in immunology · 2025Pooled it
- Central nervous system infections in patients with systemic lupus erythematosus: a systematic review and meta-analysis.Lupus science & medicine · 2022Pooled it
- The risk of infections in adult patients with systemic lupus erythematosus: systematic review and meta-analysis.Rheumatology (Oxford, England) · 2021Pooled it
- American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID-19 Pandemic: Version 1.Arthritis & rheumatology (Hoboken, N.J.) · 2020Guideline
- Pooled it
- Cotrimoxazole for infection prevention in glomerulonephritis treated with rituximab: a randomized controlled trial.BMC medicine · 2025Trial
- Development and temporal validation of a clinical prediction model to identify bacterial infection in hospitalised patients with systemic lupus erythematosus.Lupus science & medicine · 2026Article
- Double Trouble: An Uncommon Case of Ocular Toxoplasmosis in a Systemic Lupus Erythematosus (SLE) Patient.Cureus · 2026Article
- Tacrolimus associated with lower infection risk compared to conventional immunosuppressants in systemic lupus erythematosus: real-world evidence.Clinical rheumatology · 2026Article
- Systemic lupus erythematosus-driven accelerated atherosclerosis: the immune-metabolic-vascular axis and therapeutic implications.Frontiers in immunology · 2026Review
- Understanding the Evidence Gaps in the Epidemiology and Burden of Lupus Nephritis and Membranous Nephropathy: A Targeted Literature Review.Journal of health economics and outcomes research · 2026Review
- Role of antimalarials in lupus nephritis: a narrative review.Clinical rheumatology · 2025Review
- Association of disease-modifying antirheumatic drug selection with hospitalised infection among youth with childhood-onset systemic lupus erythematosus.Lupus science & medicine · 2025Article
- Article
- Serum bactericidal activity against meningococcus in patients with systemic lupus erythematosus.Clinical and experimental pediatrics · 2025Article
- Peripartum maternal outcomes in individuals with systemic lupus erythematosus in a real-world electronic health record cohort.Seminars in arthritis and rheumatism · 2025Article
- Incidence of serious respiratory tract infections and associated characteristics in a population exposed to immunosuppressive therapies: a register-based population study.BMC infectious diseases · 2024Article
- Hydroxychloroquine as an add-on therapy for the induction therapy of MPO-AAV: a retrospective observational cohort study.Clinical kidney journal · 2024Article
- Prognostic analysis of concurrent Pneumocystis jirovecii pneumonia in patients with systemic lupus erythematosus: a retrospective study.BMC infectious diseases · 2024Article
39 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveTo examine the epidemiology of serious infections, a significant cause of morbidity and mortality in systemic lupus erythematosus (SLE), in a nationwide cohort of SLE and lupus nephritis (LN) patients.
methodsUsing the Medicaid Analytic eXtract database for the years 2000-2006, we identified patients ages 18-64 years who had SLE and the subset who had LN. We ascertained cases of serious hospitalized infections using validated algorithms, and we determined 30-day mortality rates. Poisson regression was used to calculate infection incidence rates and multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) for the first infection, adjusted for sociodemographic variables, medication use, and an SLE-specific risk adjustment index.
resultsWe identified 33,565 patients with SLE, 7,113 of whom had LN. There were 9,078 serious infections in 5,078 SLE patients and 3,494 infections in 1,825 LN patients. The infection incidence rate per 100 person-years was 10.8 in the SLE cohort and 23.9 in the LN subcohort. In adjusted models for the SLE cohort, we observed increased risks of infection in men as compared to women (HR 1.33 [95% confidence interval (95% CI) 1.20-1.47]), in blacks as compared to whites (HR 1.14 [95% CI 1.06-1.21]), and in users of glucocorticoids (HR 1.51 [95% CI 1.43-1.61]) and immunosuppressive drugs (HR 1.11 [95% CI 1.03-1.20]) as compared to never users. Hydroxychloroquine users had a reduced risk of infection as compared to never users (HR 0.73 [95% CI 0.68-0.77]). The 30-day mortality rate per 1,000 person-years among those hospitalized with infections was 21.4 in the SLE cohort and 38.6 in the LN subcohort.
conclusionIn this diverse, nationwide cohort of SLE patients, we observed a substantial burden of serious infections with many subsequent deaths, particularly among those with LN.
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