ArticleKidney international reports2025
Systematic Review and Network Meta-Analysis of Initial Treatments for Lupus Nephritis.
Article in Kidney international reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- Towards a global collaborative approach to living guideline development in rheumatology.Nature reviews. Rheumatology · 2026Article
- From immune dysregulation to renal injury: mechanistic insights and translational opportunities in immune-mediated nephropathies.Frontiers in cell and developmental biology · 2026Review
- Is Monotherapy Enough? Rethinking Strategies for Active Lupus Nephritis Network Meta-Analysis of Active Lupus Nephritis Treatment.Kidney international reports · 2025Article
- Hyperoside ameliorates lupus nephritis by suppressing AKT1-mediated PANoptosis in podocytes: integrating network pharmacology and experimental validation.Frontiers in pharmacology · 2025Article
Corrections and comments
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: This study aimed to evaluate the comparative efficacy and safety of various initial treatments for active lupus nephritis (LN) through a systematic review and network meta-analysis (NMA). Methods: We conducted a comprehensive literature search across multiple databases from inception to February 2025 to identify randomized controlled trials (RCTs) comparing initial treatments for LN. We performed a frequentist random-effects NMA using the restricted maximum likelihood method to estimate heterogeneity. We used the GRADE approach to assess the certainty of evidence. Results: We included 40 RCTs encompassing 5450 patients and 16 interventions (12 drugs administered alone or in combination). Mycophenolic acid analogs (MPAAs) were selected as the common comparator. The network meta-analysis revealed that voclosporin (VCS) combined with MPAA (risk difference [RD]: 281.38 more/1000, 95% confidence interval [CI]: 146.26 more to 456.42 more; high certainty), belimumab (BEL) combined with MPAA (RD: 145.02 more/1000, 95% CI: 72.73 more to 230.92 more; high certainty), and obinutuzumab (OBI) combined with MPAA (RD: 134.23 more/1000, 95% CI: 30.37 more to 269.68 more; moderate certainty) increased complete renal response (CRR) compared with MPAA alone. Tacrolimus (TAC) combined with MPAA (RD: 113.69 more/1000, 95% CI: 25.23 more to 217.7 more; low certainty) also showed potential benefits but with low certainty evidence. Conclusion: Combination therapies, particularly VCS, BEL, or OBI with MPAA, provide enhanced outcomes for LN initial treatment. Given the complexity of LN, clinicians should weigh these findings alongside considerations such as drug availability, cost, and individual patient preferences to guide treatment decisions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.