Evidence map›Paper›PMID 41083618›Full record

ArticleScientific reports2025

Factors influencing the choice of non-biologic versus biologic immunosuppressive therapy in systemic lupus erythematosus.

Alessandra Bortoluzzi, Antonio Marangoni, Ettore Silvagni, Davide Rozza, Elena Bartoloni, Jelena Blagojevic, Francesca Bobbio Pallavicini, Enrica Bozzolo, Valentina Canti, Lorenzo Cavagna and 32 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Alessandra BortoluzziSection of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria Di Ferrara, Cona (Fe), Italy. brtlsn1@unife.it.
Antonio MarangoniSection of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria Di Ferrara, Cona (Fe), Italy.
Ettore SilvagniSection of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria Di Ferrara, Cona (Fe), Italy.
Davide RozzaEpidemiology Unit, Italian Society of Rheumatology, Milan, Italy.
Elena BartoloniRheumatology Unit, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Jelena BlagojevicRheumatology Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Francesca Bobbio PallaviciniDivision of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Enrica BozzoloIRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy.
Valentina CantiIRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy.
Lorenzo CavagnaDivision of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Ilaria CavazzanaRheumatology and Clinical Immunology Unit, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Laura ColadonatoRheumatology Unit, Department of Precision and Regenerative Medicine, University of Bari, Bari, Italy.
Paola ConigliaroRheumatology, Allergology and Clinical Immunology, Department of "Medicina Dei Sistemi", University of Rome "Tor Vergata", Rome, Italy.
Francesca CrisafulliRheumatology and Clinical Immunology Unit, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Maria Chiara DittoRheumatology Unit, Azienda Ospedaliera Città Della Salute e Della Scienza Di Torino, Turin, Italy.
Giacomo EmmiDepartment of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
Sara FerrignoRheumatology, Allergology and Clinical Immunology, Department of "Medicina Dei Sistemi", University of Rome "Tor Vergata", Rome, Italy.
Franco FranceschiniRheumatology and Clinical Immunology Unit, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Micol FrassiRheumatology and Clinical Immunology Unit, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Carlo GaraffoniSection of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria Di Ferrara, Cona (Fe), Italy.
Maria GerosaIstituto Ortopedico Gaetano Pini, Milan, Italy.
Marcello GovoniSection of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria Di Ferrara, Cona (Fe), Italy.
Serena GuiducciRheumatology Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Luca IaccarinoRheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.
Angelo ManfrediIRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy.
Silvia MancusoDipartimento Di Scienze Cliniche, Internistiche, Anestesiologiche E Cardiovascolari (SCIAC), Sapienza University, Rome, Italy.
Marta MoscaDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Caterina NaclerioRheumatology Unit, Scarlato Hospital, Scafati (Sa), Italy.
Valeria OreficeRheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy.
Simone ParisiRheumatology Unit, Azienda Ospedaliera Città Della Salute e Della Scienza Di Torino, Turin, Italy.
Giulia PazzolaAzienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy.
Giorgio PettitiAzienda Sanitaria Ospedaliera S.Croce e Carle, Cuneo, Italy.
Immacolata PreveteRheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy.
Giuseppe Alvise RamirezIRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy.
Chiara SciroccoRheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy.
Francesca Romana SpinelliDipartimento Di Scienze Cliniche, Internistiche, Anestesiologiche E Cardiovascolari (SCIAC), Sapienza University, Rome, Italy.
Margherita ZenRheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.
Greta CarraraEpidemiology Unit, Italian Society of Rheumatology, Milan, Italy.
Carlo Alberto ScirèEpidemiology Unit, Italian Society of Rheumatology, Milan, Italy.
Fabrizio ContiDipartimento Di Scienze Cliniche, Internistiche, Anestesiologiche E Cardiovascolari (SCIAC), Sapienza University, Rome, Italy.
Andrea DoriaRheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.
Gian Domenico SebastianiRheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In systemic lupus erythematosus (SLE), treatment decisions are guided by clinical judgment based on disease manifestations and safety profiles rather than standardized protocols, particularly for extra-renal involvement. In this study of 356 SLE patients, 190 receiving non-biologic immunosuppressants and 166 receiving biologics, we investigated the association of clinical phenotypes with treatment initiation and the impact of damage (SLICC-DI), comorbidities, and hospitalization history on these choices. Dominant clinical phenotypes were defined qualitatively using BILAG and SLEDAI domains. Logistic regression models with Simes-Hochberg correction revealed that renal phenotypes were strongly associated with mycophenolate initiation (OR = 4.09, p < 0.001), musculoskeletal phenotypes with methotrexate (OR = 4.86, p < 0.001). Belimumab was preferentially initiated in patients with musculoskeletal involvement and high SLEDAI scores (OR = 1.84, p = 0.03; OR = 2.03, p = 0.03, respectively). Notably, the association between mycophenolate and the renal phenotype persisted in the presence of comorbidities but was not observed in patients with SLICC-DI > 0 or more than one hospitalization in the previous year. Similarly, methotrexate and belimumab associations were diminished in patients with a Charlson comorbidity index > 1 or damage (SLICC-DI > 0). This study offers novel insights into the clinical determinants of immunosuppressive therapy selection in SLE and underscore the potential for tailoring treatment strategies to individual patient profiles.

Indexed as

Immunosuppressive AgentsLupus Erythematosus, SystemicAdultAntibodies, Monoclonal, HumanizedComorbidityFemaleHumansMaleMethotrexateMiddle AgedMycophenolic AcidAntibodies, Monoclonal, HumanizedbelimumabImmunosuppressive AgentsMethotrexateMycophenolic AcidComorbidityLupus erythematosusOrgan damageTreatment

Identifiers

PMID41083618
PMCPMC12518663

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.