SynthesisFrontiers in immunology2026
Efficacy and safety of six immunoadsorption treatments for severe lupus nephritis: a Bayesian network meta-analysis and systematic review.
Synthesis in Frontiers in immunology, 2026. 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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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.
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6 authors.
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Abstract
Background: Severe lupus nephritis (LN) remains difficult to manage despite standard immunosuppressive therapy. Immunoadsorption (IA) has been increasingly used as an adjunctive treatment. However, comparative evidence across different IA columns is limited. Methods: We conducted a systematic review and Bayesian network meta-analysis of randomized controlled trials evaluating six IA columns for severe LN. PubMed, Embase, Scopus, Web of Science, VIP, Wanfang, and CNKI were searched up to January 2025. Outcomes included disease activity (Systemic Lupus Erythematosus Disease Activity Index, SLEDAI), renal parameters, immunological markers, and adverse events. Risk of bias was assessed using the Cochrane risk-of-bias tool, and Bayesian network meta-analysis was performed in R (version 4.4.1). Results: A total of 24 randomized controlled trials involving 1,442 patients were included. DNA280 plus conventional pharmacotherapy showed a favorable probability ranking for SLEDAI improvement. DNA280 plus plasma exchange (PE) plus conventional pharmacotherapy showed a statistically significant advantage Conclusions: IA strategies-in particular DNA280-based regimens-may offer relative advantages for severe LN. However, the evidence is limited by study quality, heterogeneity, sparse comparisons for some columns, and reliance on surrogate outcomes. The findings should be interpreted as hypothesis-generating, and higher-quality comparative trials with clinically meaningful endpoints are needed. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251031348.
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