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Conventional treatments, particularly glucocorticoids (GCs), raise infection risk. This retrospective cohort study aims to investigate the association of Traditional Chinese Medicine (TCM) use with sepsis incidence, mortality, and GC dependence in patients with SLE, based on data from the Chang Gung Research Database (CGRD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients in Taiwan with newly diagnosed SLE were enrolled from the CGRD between 2005 and 2020. They were stratified into groups based on TCM treatment post\u2010diagnosis. Outcomes included sepsis incidence and the dose and duration of GC usage. Data were analyzed using Cox proportional hazard models and Kaplan\u2013Meier analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 10\u2009846 newly diagnosed patients with SLE, of whom 1801 received at least 28\u2009days of TCM treatment, while 8302 did not. After propensity score matching, 5403 and 1801 individuals were included in the non\u2010TCM and TCM groups, respectively, with no significant baseline differences in age, sex, biochemical profiles, and comorbidities between the groups. Integrative TCM usage was associated with a significantly lower risk of sepsis (adjusted hazard ratio [aHR]: 0.49; 95% confidence interval [CI]: 0.40\u20130.60, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and mortality rate (aHR 0.52, 95% CI 0.44\u20130.60, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) over an 18\u2010year period. Additionally, the TCM group had a significantly lower daily GC dose (1.74 vs. 2.47\u2009units\/day; <jats:italic>p<\/jats:italic>\u2009=\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TCM use was significantly associated with lower risks of sepsis and lower GC dosage in patients with SLE, suggesting its potential as an integrative therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.70403","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T08:47:48Z","timestamp":1756111668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Traditional Chinese Medicine Use and Sepsis Risk and Glucocorticoid Exposure in Patients With Systemic Lupus Erythematosus: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"given":"Chiao\u2010Hsuan","family":"Chu","sequence":"first","affiliation":[{"name":"Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han\u2010Hua","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology Linkou Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei\u2010Jen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Center for Traditional Chinese Medicine Chang Gung Memorial Hospital  Taoyuan Taiwan"},{"name":"School of Traditional Chinese Medicine, College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsuan\u2010Shu","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation  Hualien Taiwan"},{"name":"Sports Medicine Center Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation  Hualien Taiwan"},{"name":"School of Post\u2010Baccalaureate Chinese Medicine Tzu Chi University  Hualien Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3463-7440","authenticated-orcid":false,"given":"Po\u2010Chuan","family":"Ko","sequence":"additional","affiliation":[{"name":"Center for Big Data Analytics and Statistics Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Yi","family":"Cheng","sequence":"additional","affiliation":[{"name":"Center for Big Data Analytics and Statistics Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2273-6217","authenticated-orcid":false,"given":"Chen\u2010Ying","family":"Wei","sequence":"additional","affiliation":[{"name":"Division of Chinese Internal Medicine, Center for Traditional Chinese Medicine Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2018.11.005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2023-224762"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(14)60128\u20108"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1191\/096120301675075008"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex286"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312119835043"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-019-0424-y"},{"issue":"4","key":"e_1_2_10_9_1","first-page":"167","article-title":"Intensive Research on the Prospective Use of Complementary and Alternative Medicine to Treat Systemic Lupus Erythematosus","volume":"7","author":"Jiao B.","year":"2013","journal-title":"Drug Discoveries & Therapeutics"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11655\u2010021\u20103497\u20100"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075\u2010021\u201002649\u2010x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1185809"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4713"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1710\u20101492\u20109\u201030"},{"key":"e_1_2_10_15_1","first-page":"1209","volume-title":"Goodman and Gilman's the Pharmacological Basis of Therapeutics","author":"Schimmer B. 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