{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T11:15:55Z","timestamp":1768562155881,"version":"3.49.0"},"reference-count":104,"publisher":"The Journal of Rheumatology","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To compare benefits and harms of lupus nephritis (LN) induction and maintenance treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>We performed a systematic review and Bayesian network metaanalyses of randomized controlled trials (RCT) of immunosuppressive drugs or corticosteroids (CS) in LN. OR and 95% credible intervals (CrI) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>There were 65 RCT that met inclusion and exclusion criteria. Significantly lower risk of endstage renal disease (ESRD; 17 studies) was seen with cyclophosphamide (CYC; OR 0.49, 95% CrI 0.25\u20130.92) or CYC + azathioprine (AZA; OR 0.18, 95% CrI 0.05\u20130.57) compared with standard-dose CS, and with high-dose (HD) CYC (OR 0.16, 95% CrI 0.03\u20130.61) or CYC + AZA (OR 0.10, 95% CrI 0.03\u20130.34) compared with HD CS. HD CS was associated with higher risk of ESRD compared with CYC (OR 3.59, 95% CrI 1.30\u20139.86), AZA (OR 2.93, 95% CrI 1.08\u20138.10), or mycophenolate mofetil (MMF; OR 7.05, 95% CrI 1.66\u201331.91). Compared with CS, a significantly higher proportion of patients had renal response (14 studies) when treated with CYC (OR 1.98, 95% CrI 1.13\u20133.52), MMF (OR 2.42, 95% CrI 1.27\u20134.74), or tacrolimus (TAC; OR 4.20, 95% CrI 1.29\u201313.68). No differences were noted for the risk of malignancy (15 studies). The risk of herpes zoster (17 studies) was as follows: OR (95% CrI) MMF versus CS 4.38 (1.02\u201323.87), CYC versus CS 6.64 (1.97\u201325.71), TAC versus CS 9.11 (1.13\u201370.99), and CYC + AZA versus CS 8.46 (1.99\u201343.61).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Renal benefits and the risk of herpes zoster were higher for immunosuppressive drugs versus CS. Data on relative and absolute differences are now available, which can be incorporated into patient-physician discussions related to systemic lupus erythematosus medication use.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.160041","type":"journal-article","created":{"date-parts":[[2016,9,2]],"date-time":"2016-09-02T01:55:48Z","timestamp":1472781348000},"page":"1801-1815","source":"Crossref","is-referenced-by-count":36,"title":["Treatments for Lupus Nephritis: A Systematic Review and Network Metaanalysis"],"prefix":"10.3899","volume":"43","author":[{"given":"Jasvinder A.","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alomgir","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Kotb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy S.","family":"Mudano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Grossman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Winthrop","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George A.","family":"Wells","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2016,9,1]]},"reference":[{"key":"2018112909361651000_43.10.1801.1","doi-asserted-by":"publisher","DOI":"10.1191\/0961203302lu155oa"},{"key":"2018112909361651000_43.10.1801.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000224709.70133.f7"},{"key":"2018112909361651000_43.10.1801.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(00)70316-7"},{"key":"2018112909361651000_43.10.1801.4","doi-asserted-by":"publisher","DOI":"10.1002\/art.21458"},{"key":"2018112909361651000_43.10.1801.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000091181.93122.55"},{"key":"2018112909361651000_43.10.1801.6","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.040907"},{"key":"2018112909361651000_43.10.1801.7","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg345"},{"key":"2018112909361651000_43.10.1801.8","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21664"},{"key":"2018112909361651000_43.10.1801.9","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.12.1383"},{"key":"2018112909361651000_43.10.1801.10","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.4.279"},{"key":"2018112909361651000_43.10.1801.11","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200008)43:8<1801::AID-ANR16>3.0.CO;2-O"},{"key":"2018112909361651000_43.10.1801.12","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.131995"},{"key":"2018112909361651000_43.10.1801.13","first-page":"CD002922","article-title":"Treatment for lupus nephritis","volume":"12","author":"Henderson","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2018112909361651000_43.10.1801.14","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.141650"},{"key":"2018112909361651000_43.10.1801.15","doi-asserted-by":"crossref","unstructured":"Singh JA Wells GA Christensen R Tanjong Ghogomu E Maxwell L Macdonald JK Adverse effects of biologics: a network meta-analysis and Cochrane overview. 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