Evidence map›Paper›PMID 40702560›Full record

ArticleArthritis research & therapy2025

Prevalence and outcomes of a pilot definition of severe refractory systemic lupus erythematosus: observations from a multinational Asia-Pacific cohort.

Rangi Kandane-Rathnayake, Worawit Louthrenoo, C S Lau, Laniyati Hamijoyo, Jiacai Cho, Aisha Lateef, Shue Fen Luo, Yeong-Jian Wu, Sandra Navarra, Leonid Zamora and 29 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

39 authors.

Rangi Kandane-RathnayakeCentre for Inflammatory Diseases, School of Clinical Sciences, Monash University, VIC, Clayton, Australia. rangi.kandane-rathnayake@monash.edu.ORCID 0000-0001-5397-1482
Worawit LouthrenooDepartment of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
C S LauDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
Laniyati HamijoyoDepartment of Internal Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
Jiacai ChoRheumatology Division, Department of Medicine, National University Hospital, Singapore, Singapore.
Aisha LateefDepartment of Rheumatology, Division of Medicine, Woodlands Health, Singapore, Singapore.
Shue Fen LuoDepartment of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Yeong-Jian WuDepartment of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China.
Sandra NavarraSection of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines.
Leonid ZamoraSection of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines.
Zhanguo LiDepartment of Rheumatology and Immunology, People's Hospital, Peking University Health Science Center, Beijing, China.
Yi-Hsing ChenDivision of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Shereen OonDepartment of Rheumatology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
Madelynn ChanDepartment of Rheumatology, Allergy & Immunology, Tan Tock Seng Hospital, Tan Tock Seng, Singapore.
Sargunan SockalingamDepartment of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia.
Yanjie HaoDepartment of Rheumatology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
Zhuoli ZhangRheumatology and Immunology department, Peking University First Hospital, Beijing, China.
Sang-Cheol BaeHanyang University Hospital for Rheumatic Diseases, Hanyang University Institute for Rheumatology Research and Hanyang Institute of Bioscience and Biotechnology, Seoul, South Korea.
Jun KikuchiDepartment of Internal Medicine, Keio University, Tokyo, Japan.
Tsutomu TakeuchiDepartment of Internal Medicine, Keio University, Tokyo, Japan.
Yasuhiro KatsumataDepartment of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Bmdb BasnayakeDepartment of Nephrology, Teaching Hospital Kandy, Kandy, Sri Lanka.
Fiona GoldblattDepartment of Rheumatology, Flinders Medical Centre, Bedford Park, SA, Australia.
Sean O'NeillRheumatology Department, Liverpool Hospital, Liverpool, NSW, Australia.
Kristine Pek Ling NgDepartment of Rheumatology, North Shore Hospital, Health New Zealand Waitemata, Auckland, New Zealand.
Nicola TugnetDepartment of Rheumatology, Greenlane Clinical Centre, Health New Zealand Auckland, Te Whatu Ora, Auckland, New Zealand.
Mark SapsfordDepartment of Rheumatology, Middlemore Hospital, Health New Zealand Counties Manukau, Te Whatu Ora, Auckland, New Zealand.
Yih Jia PohDepartment of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.
Cherica TeeCollege of Medicine, University of the Philippines, Manila, Philippines.
Michael TeeCollege of Medicine, University of the Philippines, Manila, Philippines.
Naoaki OhkuboThe First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Adrienne O'Donnell LefeberNovartis Pharma, Basel, Switzerland.
Tamas ShishaNovartis Pharma, Basel, Switzerland.
Yoshiya TanakaThe First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Vera GolderCentre for Inflammatory Diseases, School of Clinical Sciences, Monash University, VIC, Clayton, Australia.
Mandana NikpourDepartment of Rheumatology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.
Alberta HoiCentre for Inflammatory Diseases, School of Clinical Sciences, Monash University, VIC, Clayton, Australia.
Peter GergelyNovartis Pharma, Basel, Switzerland.
Eric MorandCentre for Inflammatory Diseases, School of Clinical Sciences, Monash University, VIC, Clayton, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmerging therapies have the potential to be used in patients with severe refractory systemic lupus erythematosus (srSLE), but no agreed definition of srSLE exists. We evaluated a pilot srSLE definition to assess whether a set of disease activity and treatment thresholds could identify patients with poor outcomes.

methodsData from a 13-country longitudinal SLE cohort, collected prospectively between 2013 and 2020 were analysed. srSLE was defined if a patient was in high disease activity (SLEDAI-2K ≥ 10) despite combination use of at least glucocorticoids (GC) and immunosuppressants (IS) at both the index and preceding visit. Synchronised to the index srSLE visit, we assessed disease activity, medication use and treat-to-target (T2T) endpoint attainment over 12 months (m).

resultsOf 3,744 patients studied, 578 (14%) had srSLE, in 1,810 visits. The median [IQR] SLEDAI-2K at the srSLE index visit was 12 [10, 14], which decreased to 6 [4, 10] at 6m and 12m. Most patients remained on combination anti-malarial, GC, and IS at all follow-up time points. The median [IQR] GC dose at the index visit was 10 [5, 20] mg/day; this reduced to 8 mg [5.0, 12.9] at 6m and 5 mg [5.0, 10.0] at 12m. Less than a quarter of patients attained LLDAS and only 1% attained GC-free remission over 12 months.

conclusionsA draft definition of srSLE was clearly associated with poor outcomes. Work to evaluate multiple thresholds with which to define srSLE, and their outcomes, is warranted.

Indexed as

Lupus Erythematosus, SystemicAdultAntimalarialsAsiaCohort StudiesDrug Therapy, CombinationFemaleGlucocorticoidsHumansImmunosuppressive AgentsLongitudinal StudiesMaleMiddle AgedPilot ProjectsPrevalenceProspective StudiesAntimalarialsGlucocorticoidsImmunosuppressive AgentsPoor outcomesSevere refractory diseaseSystemic lupus erythematosus (SLE)

Identifiers

PMID40702560
PMCPMC12288243

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.