{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:21:38Z","timestamp":1788351698294,"version":"build-2803163510"},"reference-count":16,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"unspecified","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,4,28]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of systemic lupus erythematosus (SLE) is largely guided by organ involvement. Serositis affects up to 46% of patients, yet its treatment is mainly empirical and extrapolated from other manifestations, and long-term outcome data remain limited. We aimed to evaluate short-term response to anti-inflammatory therapy and to examine associations between immunosuppressive treatments and serositis relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicentre retrospective real-world study in patients with SLE with pericarditis and\/or pleuritis, identified through a nationwide call for case reporting. Initial response was defined as symptom and sign resolution at early reassessment. Relapse was defined as recurrence requiring treatment intensification \u22653 months after the index flare. Relapse-free survival was described by Kaplan\u2013Meier methods and analysed as recurrent events using a Prentice-Williams-Peterson gap-time Cox model adjusted for prespecified confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred patients contributed 180 serositis episodes (161 pericarditis, 51 pleuritis, associated in 32 cases) over a mean follow-up of 91 months; 46% experienced \u22651 relapse. Overall, 108\/124 (87.1%) of evaluable episodes responded to initial anti-inflammatory therapy, with no significant difference between corticosteroid-based and aspirin\/colchicine regimens. Corticosteroid use was not associated with increased relapse risk (46.0% vs 46.2%, p=0.98). Conventional immunosuppressants (methotrexate, azathioprine, mycophenolate mofetil) were not associated with reduced relapse risk, whereas belimumab was associated with lower relapse risk (HR=0.34, 95%\u2009CI 0.14 to 0.84; p=0.019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lupus-related serositis is frequent and highly relapsing. In this national cohort, belimumab\u2014but not conventional immunosuppressants\u2014was associated with reduced serositis recurrence, supporting its further evaluation in lupus serositis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2026-006919","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:26:31Z","timestamp":1778682391000},"page":"e006919","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Relapse risk of lupus-related serositis according to immunosuppressive therapy: a national real-world study"],"prefix":"10.1136","volume":"12","author":[{"given":"Elodie","family":"Fels","sequence":"first","affiliation":[{"name":"Rheumatology Department, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Goncalves","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, H\u00f4pital Haut-Lev\u00eaque, Bordeaux University Hospital, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5479-5887","authenticated-orcid":false,"given":"Sandrine","family":"Jousse-Joulin","sequence":"additional","affiliation":[{"name":"Rheumatology Department, National Reference Center for Systemic Autoimmune Diseases (CERAINO), H\u00f4pital La Cavale-Blanche, UMR INSERM 1227, Brest University Hospital, Brest, France"},{"name":"Rheumatology Department, Ferdinand Grall Hospital, Landerneau, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0582-694X","authenticated-orcid":false,"given":"Laurent","family":"Chiche","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, H\u00f4pital Europ\u00e9en, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Korganow","sequence":"additional","affiliation":[{"name":"Clinical Immunology and Internal Medicine Department, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Martin","sequence":"additional","affiliation":[{"name":"Clinical Immunology and Internal Medicine Department, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8077-8394","authenticated-orcid":false,"given":"Laurent","family":"Arnaud","sequence":"additional","affiliation":[{"name":"Rheumatology Department, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Ottaviani","sequence":"additional","affiliation":[{"name":"Rheumatology Department, H\u00f4pital Bichat, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4206-7399","authenticated-orcid":false,"given":"Estibaliz","family":"Lazaro","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, H\u00f4pital Haut-Lev\u00eaque, Bordeaux University Hospital, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Sibilia","sequence":"additional","affiliation":[{"name":"Rheumatology Department, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France"},{"name":"UMR INSERM 1109 Immuno-rhumatologie Mol\u00e9culaire CRBS, 1 rue Koeberl\u00e9, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5454-903X","authenticated-orcid":false,"given":"Ludovic","family":"Trefond","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, National Reference Center for Systemic Autoimmune Diseases (CERAINAUV), M2iSH, UMR INSERM 1071, Clermont-Ferrand University Hospital, Clermont-Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9453-5895","authenticated-orcid":false,"given":"Marc","family":"Scherlinger","sequence":"additional","affiliation":[{"name":"Rheumatology Department, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France"},{"name":"UMR INSERM 1109 Immuno-rhumatologie Mol\u00e9culaire CRBS, 1 rue Koeberl\u00e9, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"2026090205003002000_12.2.e006919.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1100359"},{"key":"2026090205003002000_12.2.e006919.2","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1038\/s41573-025-01242-0","article-title":"Advances in the treatment of systemic lupus erythematosus","volume":"24","author":"Scherlinger","year":"2025","journal-title":"Nat Rev Drug Discov"},{"key":"2026090205003002000_12.2.e006919.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.09.002"},{"key":"2026090205003002000_12.2.e006919.4","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ard.2025.09.007","article-title":"EULAR recommendations for the management of systemic lupus erythematosus with kidney involvement: 2025 update","volume":"85","author":"Fanouriakis","year":"2026","journal-title":"Ann Rheum Dis"},{"key":"2026090205003002000_12.2.e006919.5","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.revmed.2024.07.006","article-title":"French protocol for the diagnosis and management of systemic lupus erythematosus","volume":"45","author":"Amoura","year":"2024","journal-title":"Rev Med Interne"},{"key":"2026090205003002000_12.2.e006919.6","doi-asserted-by":"publisher","DOI":"10.1378\/chest.84.6.714"},{"key":"2026090205003002000_12.2.e006919.7","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2009.064311"},{"key":"2026090205003002000_12.2.e006919.8","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.61610","article-title":"Incidence and factors associated with recurrent pericarditis in lupus","volume":"8","author":"Kim","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026090205003002000_12.2.e006919.9","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214819"},{"key":"2026090205003002000_12.2.e006919.10","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq376"},{"key":"2026090205003002000_12.2.e006919.11","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1002\/art.40511","article-title":"Efficacy and safety of subcutaneous belimumab in anti-double-stranded DNA-positive, hypocomplementemic patients with systemic lupus erythematosus","volume":"70","author":"Doria","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"2026090205003002000_12.2.e006919.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001180"},{"key":"2026090205003002000_12.2.e006919.13","doi-asserted-by":"crossref","DOI":"10.1126\/sciimmunol.adr6376","article-title":"Immunobiology of the serous cavities","volume":"11","author":"Parkinson","year":"2026","journal-title":"Sci Immunol"},{"key":"2026090205003002000_12.2.e006919.14","doi-asserted-by":"publisher","DOI":"10.1172\/JCI200318025"},{"key":"2026090205003002000_12.2.e006919.15","doi-asserted-by":"crossref","DOI":"10.1136\/lupus-2020-000459","article-title":"Efficacy of belimumab in two serologically distinct high disease activity subgroups of patients with systemic lupus erythematosus: post-hoc analysis of data from the phase III programme","volume":"8","author":"Maslen","year":"2021","journal-title":"Lupus Sci Med"},{"key":"2026090205003002000_12.2.e006919.16","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200831"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2026-006919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:00:51Z","timestamp":1788350451000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2026-006919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,5,13]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/rmdopen-2026-006919"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2026-006919","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}