{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T00:54:10Z","timestamp":1794012850521,"version":"4.8.0"},"reference-count":46,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_rir-2025-0011_s_101\">\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>No prior studies have directly compared sirolimus with the standard of care (SoC) for lupus nephritis (LN) patients. This study aimed to compare the efficacy and safety of sirolimus with mycophenolate mofetil (MMF) for the treatment of LN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_rir-2025-0011_s_102\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A real-world cohort study based on the Chinese SLE Treatment and Research (CSTAR) registry was conducted. Patients with active LN who were prescribed either sirolimus or MMF were enrolled. Propensity score matching was applied to ensure comparable baseline disease conditions. SLE disease activity indices, serological parameters, steroid doses, renal efficacy, and adverse events were evaluated at 3-month, 6-month, and 12-month follow-ups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_rir-2025-0011_s_103\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data from 53 patients in each group were analyzed. Sirolimus demonstrated clinical effectiveness comparable to MMF, as evidenced by similar rates of lupus nephritis remission and lupus low disease activity state (LLDAS) \/remission or a clinical response (reduction of SLE Disease Activity Index 2000 [SLEDAI-2K] \u22654 and increase in physician\u2019s global assessment [PhGA] &lt; 0.3), as well as changes in 24-hour urine protein level, SLEDAI-2K score, PhGA score, and steroid tapering effect (<jats:italic>P<\/jats:italic> \u2265 0.05 at all follow-up timepoints). Notably, sirolimus group exhibited greater improvements in complement levels compared to MMF group at 3, 6, and 12 months. Ten adverse events in sirolimus group and one in MMF group were reported, with no severe adverse events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_rir-2025-0011_s_104\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Sirolimus demonstrated comparable efficacy to MMF in the treatment of LN and glucocorticoid tapering, with additional benefits in serological improvement. Furthermore, sirolimus was well tolerated in LN patients, supporting its potential as a therapeutic option for LN.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/rir-2025-0011","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T17:55:18Z","timestamp":1751392518000},"page":"80-89","source":"Crossref","is-referenced-by-count":11,"title":["Sirolimus versus mycophenolate mofetil for the treatment of lupus nephritis: Results from a real-world CSTAR cohort study"],"prefix":"10.1515","volume":"6","author":[{"given":"Wei","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liying","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinli","family":"Gui","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, People\u2019s Hospital of Zhengzhou , Henan Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunzhuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, People\u2019s Hospital of Zhengzhou , Henan Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwang","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The Second Affiliated Hospital of Nanchang University , Nanchang , Jiangxi Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Second Hospital of Shanxi Medical University , Taiyuan , Shanxi Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongfeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The First Affiliated Hospital of Dalian Medical University , Dalian , Liaoning Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuehong","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The Fifth People\u2019s Hospital of Datong , Shanxi Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The First Affiliated Hospital of Kunming Medical University , Kunming , Yunnan Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingting","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The First Hospital of China Medical University , Shenyang , Liaoning Province , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Bio-statistics (YW), Institute of Basic Medical Science, Chinese Academy of Medical Science & Peking Union Medical College , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanyuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiuliang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomei","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinping","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengtao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2025070117550988232_j_rir-2025-0011_ref_001","doi-asserted-by":"crossref","unstructured":"Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism\/American College of Rheumatology classification criteria for systemic lupus erythematosus. 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