{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:50:02Z","timestamp":1782125402088,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Glucocorticoids rapidly control inflammation in systemic lupus erythematosus (SLE), yet prolonged use contributes to organ damage and increased mortality. Optimal tapering strategies in newly diagnosed, treatment\u2010na\u00efve patients remain unclear. This study aimed to identify predictors for glucocorticoid tapering, focusing on early belimumab initiation and the safety of high\u2010dose induction therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied newly diagnosed, treatment\u2010na\u00efve SLE patients initiated on prednisolone (PSL) &gt;\u200920\u2009mg\/day between April 2006 and April 2024. Early belimumab exposure was defined as initiation of therapy within 26\u2009weeks of diagnosis with continuation for at least 26\u2009weeks. Kaplan\u2013Meier analysis determined the time to achieve PSL \u2264\u20097.5 mg\/day\u00a0and \u2264\u20095\u2009mg\/day. Cox proportional hazards models identified factors associated with early tapering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 537 patients, 106 met the inclusion criteria. The median initial PSL dose was 50.0\u2009mg\/day (IQR: 30.0\u201375.0), tapering to 5.00\u2009mg\/day (IQR: 3.00\u20137.62) by week 52. Early belimumab exposure was significantly associated with tapering to \u2264\u20097.5\u2009mg\/day (HR 4.05, 95% CI: 1.95\u20138.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and showed a trend toward achieving \u2264\u20095\u2009mg\/day. Patients with early belimumab exposure also had significantly higher LLDAS attainment (HR 4.07, CI 1.97\u20138.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). High\u2010dose induction (PSL &gt;\u200940\u2009mg\/day) and rapid tapering were not associated with delayed tapering or increased cumulative exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early belimumab initiation was associated with glucocorticoid tapering and higher LLDAS attainment in treatment\u2010na\u00efve SLE patients, potentially reducing long\u2010term steroid\u2010related risks. High\u2010dose glucocorticoid induction therapy and rapid tapering approaches appear safe without increasing cumulative glucocorticoid exposure, supporting their consideration in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70462","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T06:54:46Z","timestamp":1763189686000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Early Belimumab Use on Successful Glucocorticoid Tapering to a Low Maintenance Dose in Treatment\u2010na\u00efve, Newly Diagnosed Systemic Lupus Erythematosus"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0588-9518","authenticated-orcid":false,"given":"Takehiro","family":"Nakai","sequence":"first","affiliation":[{"name":"Immuno\u2010Rheumatology Center St. Luke's International Hospital  Tokyo 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