{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:00:30Z","timestamp":1790352030873,"version":"4.1.0"},"reference-count":53,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"unspecified","delay-in-days":97,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,9,17]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Lupus nephritis (LN) is associated with a poorer prognosis in Latin American populations. However, the contributing risk factors contributing to this remain to be fully elucidated. This study aimed to develop a prognostic model for poor renal outcomes in patients of mestizo descent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicentre, retrospective analysis including 290 adult mestizo patients with incident, biopsy-proven pure proliferative LN (International Society of Nephrology\/Renal Pathology Society (ISN\/RPS) class III or IV) from nine Chilean hospitals. Clinical, biological and histological variables were assessed. The primary outcome was a composite of stage IV\/V chronic kidney disease, dialysis or death. Predictive variables were selected using multivariable Cox regression, and prognostic scores were derived accordingly. Internal validation was performed via bootstrapping. External validation included 93 Mexican patients, with model performance assessed using Harrel\u2019s concordance index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two baseline factors were independently associated with poor renal outcome: estimated glomerular filtration rate &lt;30\u2009mL\/min\/m\n                      <jats:sup>2<\/jats:sup>\n                      (HR 3.82, 95%\u2009CI 2.15 to 6.78; p&lt;0.001) and histological chronicity index &gt;2 (HR 2.01, 95%\u2009CI 1.18 to 3.43; p=0.01). Patients were stratified into three risk categories according to the presence of none (low risk), one (intermediate risk) or both (high risk) of these factors. The likelihood of the primary outcome increased progressively across these groups: high versus intermediate risk (HR 3.22, 95%\u2009CI 1.64 to 6.34; p=0.001), and intermediate versus low risk group (HR 2.41, 95%\u2009CI 1.35 to 4.30; p=0.003). The three-tier model was replicated in the validation cohort with a concordance index of 79% (95% CI 71% to 87%; p&lt;0.001) between predicted and observed results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on two readily available features at the time of diagnosis, the proposed model effectively stratifies Latin American mestizo patients with pure proliferative LN (ISN\/RPS class III or IV) into three risk categories for poor renal outcome. This tool may support improved risk-based management in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001649","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T08:00:23Z","timestamp":1759824023000},"page":"e001649","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Prediction model for renal outcomes in Latin American Mestizo patients with pure proliferative lupus nephritis"],"prefix":"10.1136","volume":"12","author":[{"given":"Arturo","family":"Villalobos Navarro","sequence":"first","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Hospital Barros Luco Trudeau, Santiago, Chile"},{"name":"Universidad de Chile Facultad de Medicina, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Xipell","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda Gardu\u00f1o","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, UMAE Hospital de Especialidades \u2018Dr. Bernardo Sep\u00falveda G\u2019 Centro M\u00e9dico Nacional 21 Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Valjalo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital Del Salvador, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Contreras","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital Cl\u00ednico San Borja Arriar\u00e1n, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ruiz de Arechavaleta","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinica Davila, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Segura","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology, Hospital Clinico de la Universidad de Chile Jose Joaquin Aguirre, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital San Juan de Dios, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"\u00c1vila","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Hidalgo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Clinico de la Universidad de Chile Jose Joaquin Aguirre, Santiago, Chile"},{"name":"Department of Nephrology, Hospital San Jose, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0739-0449","authenticated-orcid":false,"given":"Juan Daniel","family":"Diaz Garcia","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, General Hospital of Mexico, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiola Pazos","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, UMAE Hospital de Especialidades \u2018Dr. Bernardo Sep\u00falveda G\u2019 Centro M\u00e9dico Nacional 21 Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Valderrama \u00c1vila","sequence":"additional","affiliation":[{"name":"Department of Nephrology, UMAE Hospital de Especialidades \u2018Dr. Bernardo Sep\u00falveda G\u2019 Centro M\u00e9dico Nacional 21 Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda In\u00e9s","family":"Gil Arredondo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, UMAE Hospital de Especialidades \u2018Dr. Bernardo Sep\u00falveda G\u2019 Centro M\u00e9dico Nacional 21 Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricard","family":"Cervera","sequence":"additional","affiliation":[{"name":"Hospital Clinic de Barcelona Servei de Malalties Autoimmunes, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1336-0163","authenticated-orcid":false,"given":"Gerard","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Hospital Clinic de Barcelona Servei de Malalties Autoimmunes, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hospital Clinic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Blasco","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7582-8476","authenticated-orcid":false,"given":"Luis F","family":"Quintana","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"2026010700553895000_12.2.e001649.1","doi-asserted-by":"crossref","first-page":"103404","DOI":"10.1016\/j.autrev.2023.103404","article-title":"From systemic lupus erythematosus to lupus nephritis: The evolving road to targeted therapies","volume":"22","author":"Xipell","year":"2023","journal-title":"Autoimmun Rev"},{"key":"2026010700553895000_12.2.e001649.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000091181.93122.55"},{"key":"2026010700553895000_12.2.e001649.3","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40001-022-00946-y","article-title":"Searching for a prognostic index in lupus nephritis","volume":"28","author":"Rodr\u00edguez-Almaraz","year":"2023","journal-title":"Eur J Med Res"},{"key":"2026010700553895000_12.2.e001649.4","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.10.017"},{"key":"2026010700553895000_12.2.e001649.5","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5000243"},{"key":"2026010700553895000_12.2.e001649.6","first-page":"95","article-title":"Baseline characteristics of a multiethnic lupus cohort: PROFILE","volume":"11","author":"Alarc\u00f3n","year":"2002","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000104742.42401.e2"},{"key":"2026010700553895000_12.2.e001649.8","first-page":"867","article-title":"Ethnic disparities in health and disease: the need to account for ancestral admixture when estimating the genetic contribution to both (LUMINA XXVI)","volume":"14","author":"Alarc\u00f3n","year":"2005","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.9","doi-asserted-by":"publisher","DOI":"10.1002\/art.34567"},{"key":"2026010700553895000_12.2.e001649.10","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199807)41:7<1173::AID-ART5>3.0.CO;2-A"},{"key":"2026010700553895000_12.2.e001649.11","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.79a.12048"},{"key":"2026010700553895000_12.2.e001649.12","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1002\/art.39026","article-title":"Predictors of long-term renal outcome in lupus nephritis trials: lessons learned from the Euro-Lupus Nephritis cohort","volume":"67","author":"Dall\u2019Era","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"2026010700553895000_12.2.e001649.13","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2015-000123","article-title":"A proteinuria cut-off level of 0.7\u2005g\/day after 12\u2005months of treatment best predicts long-term renal outcome in lupus nephritis: data from the MAINTAIN Nephritis Trial","volume":"2","author":"Tamirou","year":"2015","journal-title":"Lupus Sci Med"},{"key":"2026010700553895000_12.2.e001649.14","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2020-001299","article-title":"Predictors of renal damage in systemic lupus erythematous patients: data from a multiethnic, multinational Latin American lupus cohort (GLADEL)","volume":"6","author":"Re\u00e1tegui-Sokolova","year":"2020","journal-title":"RMD Open"},{"key":"2026010700553895000_12.2.e001649.15","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1002\/art.39594","article-title":"Risk of End-Stage Renal Disease in Patients With Lupus Nephritis, 1971-2015: A Systematic Review and Bayesian Meta-Analysis","volume":"68","author":"Tektonidou","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"2026010700553895000_12.2.e001649.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMOA2102953\/SUPPL_FILE\/NEJMOA2102953_DISCLOSURES.PDF"},{"key":"2026010700553895000_12.2.e001649.17","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000108969.21691.5D"},{"key":"2026010700553895000_12.2.e001649.18","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)90338-8"},{"key":"2026010700553895000_12.2.e001649.19","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.13"},{"key":"2026010700553895000_12.2.e001649.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.09.002"},{"key":"2026010700553895000_12.2.e001649.21","doi-asserted-by":"publisher","DOI":"10.1016\/J.KINT.2023.10.018"},{"key":"2026010700553895000_12.2.e001649.22","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/81.3.515"},{"key":"2026010700553895000_12.2.e001649.23","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jbi.2011.02.005","article-title":"An empirical approach to model selection through validation for censored survival data","volume":"44","author":"Choi","year":"2011","journal-title":"J Biomed Inform"},{"key":"2026010700553895000_12.2.e001649.24","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4"},{"key":"2026010700553895000_12.2.e001649.25","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90645-0"},{"key":"2026010700553895000_12.2.e001649.26","first-page":"1011","article-title":"Systemic lupus erythematosus, lupus nephritis and end-stage renal disease: a pragmatic review mapping disease severity and progression","volume":"29","author":"Mahajan","year":"2020","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.27","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000002891","article-title":"Characterization of Patients With Lupus Nephritis Included in a Large Cohort From the Spanish Society of Rheumatology Registry of Patients With Systemic Lupus Erythematosus (RELESSER)","volume":"95","author":"Galindo-Izquierdo","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"2026010700553895000_12.2.e001649.28","first-page":"810","article-title":"Progressive improvement of patient and renal survival and reduction of morbidity over time in patients with lupus nephritis (LN) followed for 20 years","volume":"22","author":"Moroni","year":"2013","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.29","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s11255-014-0903-y","article-title":"Clinicopathological and outcome analysis of adult lupus nephritis patients in China","volume":"47","author":"Tang","year":"2015","journal-title":"Int Urol Nephrol"},{"key":"2026010700553895000_12.2.e001649.30","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1984.75"},{"key":"2026010700553895000_12.2.e001649.31","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10601016"},{"key":"2026010700553895000_12.2.e001649.32","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1989.276"},{"key":"2026010700553895000_12.2.e001649.33","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40001-022-00946-y","article-title":"Searching for a prognostic index in lupus nephritis","volume":"28","author":"Rodr\u00edguez-Almaraz","year":"2023","journal-title":"Eur J Med Res"},{"key":"2026010700553895000_12.2.e001649.34","first-page":"1455","article-title":"Histological predictors of renal outcome in lupus nephritis: the importance of tubulointerstitial lesions and scoring of glomerular lesions","volume":"27","author":"Obri\u0219c\u0103","year":"2018","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.35","first-page":"1446","article-title":"Interstitial inflammation and long-term renal outcomes in lupus nephritis","volume":"22","author":"Alsuwaida","year":"2013","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.36","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330708"},{"key":"2026010700553895000_12.2.e001649.37","first-page":"371","article-title":"Predictors of renal outcome in diffuse proliferative glomerulonephritis in systemic lupus erythematosus","volume":"6","author":"Mosca","year":"1997","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.07.007"},{"key":"2026010700553895000_12.2.e001649.39","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfx093"},{"key":"2026010700553895000_12.2.e001649.40","first-page":"411","article-title":"Predicting kidney outcomes among Latin American patients with lupus nephritis: The prognostic value of interstitial fibrosis and tubular atrophy and tubulointerstitial inflammation","volume":"32","author":"Rodelo","year":"2023","journal-title":"Lupus (Los Angel)"},{"key":"2026010700553895000_12.2.e001649.41","doi-asserted-by":"crossref","first-page":"103014","DOI":"10.1016\/j.autrev.2021.103014","article-title":"Assessing and counteracting fibrosis is a cornerstone of the treatment of CKD secondary to systemic and renal limited autoimmune disorders","volume":"21","author":"de Cos","year":"2022","journal-title":"Autoimmun Rev"},{"key":"2026010700553895000_12.2.e001649.42","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1093\/ndt\/gfy220","article-title":"Standardized classification and reporting of glomerulonephritis","volume":"34","author":"Sethi","year":"2019","journal-title":"Nephrol Dial Transplant"},{"key":"2026010700553895000_12.2.e001649.43","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1016\/j.ekir.2019.06.011","article-title":"A Systematic Review of Interpathologist Agreement in Histologic Classification of Lupus Nephritis","volume":"4","author":"Dasari","year":"2019","journal-title":"Kidney Int Rep"},{"key":"2026010700553895000_12.2.e001649.44","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1038\/s41581-020-0321-6","article-title":"Digital pathology and computational image analysis in nephropathology","volume":"16","author":"Barisoni","year":"2020","journal-title":"Nat Rev Nephrol"},{"key":"2026010700553895000_12.2.e001649.45","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1097\/MNH.0000000000000360","article-title":"Digital pathology in nephrology clinical trials, research, and pathology practice","volume":"26","author":"Barisoni","year":"2017","journal-title":"Curr Opin Nephrol Hypertens"},{"key":"2026010700553895000_12.2.e001649.46","doi-asserted-by":"crossref","first-page":"607720","DOI":"10.3389\/fmed.2021.607720","article-title":"Automated Digital Quantification of Pulmonary Fibrosis in Human Histopathology Specimens","volume":"8","author":"Testa","year":"2021","journal-title":"Front Med"},{"key":"2026010700553895000_12.2.e001649.47","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2020050652"},{"key":"2026010700553895000_12.2.e001649.48","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.ekir.2017.11.002","article-title":"Association of Pathological Fibrosis With Renal Survival Using Deep Neural Networks","volume":"3","author":"Kolachalama","year":"2018","journal-title":"Kidney Int Rep"},{"key":"2026010700553895000_12.2.e001649.49","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1016\/j.ekir.2021.04.019","article-title":"Image Analysis Pipeline for Renal Allograft Evaluation and Fibrosis Quantification","volume":"6","author":"Farris","year":"2021","journal-title":"Kidney Int Rep"},{"key":"2026010700553895000_12.2.e001649.50","first-page":"2","article-title":"Latin American clinical practice guidelines for systemic lupus erythematosus: GLADEL\u2013PANLAR recommendations 2018","volume":"77","author":"Pons-Estel","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"2026010700553895000_12.2.e001649.51","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.reuma.2018.03.011","article-title":"Clinical practice guidelines for the treatment of systemic lupus erythematosus by the Mexican College of Rheumatology","volume":"15","author":"Xibill\u00e9-Friedmann","year":"2019","journal-title":"Reumatol Clin (Engl Ed)"},{"key":"2026010700553895000_12.2.e001649.52","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.4067\/S0034-98872015001200010","article-title":"Recomendaciones sobre el manejo del compromiso renal del lupus eritematoso sist\u00e9mico: Documento de Consenso de las Sociedades Chilenas de Nefrolog\u00eda y Reumatolog\u00eda","volume":"143","author":"Aguirre","year":"2015","journal-title":"Rev m\u00e9d Chile"},{"key":"2026010700553895000_12.2.e001649.53","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgen.1000037","article-title":"Geographic patterns of genome admixture in Latin American Mestizos","volume":"4","author":"Wang","year":"2008","journal-title":"PLoS Genet"}],"container-title":["Lupus Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/lupus-2025-001649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:56:26Z","timestamp":1767776186000},"score":1,"resource":{"primary":{"URL":"https:\/\/lupus.bmj.com\/lookup\/doi\/10.1136\/lupus-2025-001649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":53,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/lupus-2025-001649"],"URL":"https:\/\/doi.org\/10.1136\/lupus-2025-001649","relation":{},"ISSN":["2053-8790"],"issn-type":[{"value":"2053-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}