ArticleLupus science & medicine2018
Risk of adverse events from different drugs for SLE: a systematic review and network meta-analysis.
Article in Lupus science & medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A multidimensional analysis of neuropsychiatric lupus: clinical, biological and imaging insights from systematic evidence.Frontiers in immunology · 2026Pooled it
- Combined Immunosuppressive Therapy Induces Remission in Patients With Severe Type B Insulin Resistance: A Prospective Cohort Study.Diabetes care · 2018Trial
- Pharmacogenetics and pharmacokinetics of immunosuppressants: clinical correlations and disease activity control in Egyptian female patients with lupus nephritis.Molecular biology reports · 2026Article
- Tacrolimus associated with lower infection risk compared to conventional immunosuppressants in systemic lupus erythematosus: real-world evidence.Clinical rheumatology · 2026Article
- Restoring B cell intrinsic tolerance to lupus autoimmunity: a rational strategy for lupus treatment.Frontiers in immunology · 2026Review
- Effectiveness and safety of tacrolimus in systemic lupus erythematosus with various clinical manifestations: a retrospective real-world study.Arthritis research & therapy · 2025Article
- Factors influencing the choice of non-biologic versus biologic immunosuppressive therapy in systemic lupus erythematosus.Scientific reports · 2025Article
- Clinical Outcomes of Patients with SLE Treated with Belimumab, Without Versus With Prior Immunosuppressant Use: a US Claims Database Study.Rheumatology and therapy · 2025Article
- Medication-related hospitalisations in patients with SLE.Lupus science & medicine · 2025Article
- Establishment of subcutaneous transplantation platform for delivering induced pluripotent stem cell-derived insulin-producing cells.PloS one · 2025Article
- Infections in Patients with Systemic Lupus Erythematosus: The Contribution of Primary Immune Defects Versus Treatment-Induced Immunosuppression.European journal of rheumatology · 2023Article
- Efficacy and safety of belimumab/low-dose cyclophosphamide therapy in moderate-to-severe systemic lupus erythematosus.Frontiers in immunology · 2022Article
- Article
- The ALPHA Project: Establishing consensus and prioritisation of global community recommendations to address major challenges in lupus diagnosis, care, treatment and research.Lupus science & medicine · 2021Article
- Mechanism of Action and Efficacy of Immunosupressors in Lupus Nephritis.International journal of nephrology and renovascular disease · 2021Review
- Phytochemicals as Anti-Inflammatory Agents in Animal Models of Prevalent Inflammatory Diseases.Molecules (Basel, Switzerland) · 2020Review
- Tacrolimus for Treating Orbital and Cranial Form of Idiopathic Inflammatory Pseudotumors.Journal of clinical neurology (Seoul, Korea) · 2020Article
- West Nile encephalitis mimicking neuropsychiatric lupus in a patient with systemic lupus erythematosus.BMJ case reports · 2019Article
- Global consensus building and prioritisation of fundamental lupus challenges: the ALPHA project.Lupus science & medicine · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe comparative safety of immunosuppressive drugs, biologicals and glucocorticoids (GC) for patients with SLE remains controversial. We aimed to investigate the specific side effects of the available SLE drugs in this population of patients.
methodsElectronic databases were systematically searched through September 2017 for randomised trials in patients with SLE. The primary outcomes were all-cause mortality and withdrawal related to adverse events (AEs). We performed a random-effects network meta-analysis to obtain estimates for primary and secondary outcomes and presented these estimates as ORs with 95% CIs.
resultsForty-four studies comprising 9898 participants were included in the network meta-analysis. No drug regimen was considered to be safer for reducing all-cause mortality. However, compared with cyclophosphamide, azathioprine (OR 3.04, 95% CI (1.44 to 6.42)) and cyclosporine (OR 3.28, 95% CI (1.04 to 10.35)) were significantly less safety in AE-related withdrawals, and GC was ranked lowest and led to higher withdrawal rates. Tacrolimus (TAC) was ranked high and showed a benefit in many outcomes. Biologicals and chloroquine also showed good safety in all of the available outcomes, while the beneficial effects of other immunosuppressive drugs were not substantial in different types of serious adverse events.
conclusionsTAC is the safest strategy for patients with SLE. Biologicals and chloroquine are also fairly safe for patients with SLE. The use of other immunosuppressive drugs and GC needs to be balanced against the potential harms of different types of AEs, and the practical safety of drug combinations still requires further trials to evaluate.
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