Association of disease-modifying antirheumatic drug selection with hospitalised infection among youth with childhood-onset systemic lupus erythematosus
Authors' conclusion
We observed higher hospitalised infection rates in children with cSLE and LN compared with those without LN. Among children with LN, those who received cyclophosphamide had more infections than those who received mycophenolate.
Study context
- Population
- Youth ≤18 years with childhood-onset SLE (cSLE) treated 2009–2022 at two centres
- Participants
- 257 participants
- Exposure
- DMARD exposure groups in cSLE, stratified by lupus nephritis (LN) status
- Outcome
- Hospitalised infection
- Follow-up
- First year of treatment
Methodological detailstwo centres, inverse probability of treatment weighting (IPTW), Cox proportional hazard regression, adjusted for corticosteroid dose
- Two centres
- IPTW
- Cox proportional hazard regression
- Adjusted for corticosteroid dose
Main finding
As reported in the abstract
Hospitalised infection, IPTW-adjusted · 1 year
Hazard ratio (95% CI)
Mycophenolatevs Cyclophosphamideyouth with LN
0.12(0.019–0.88)
Mycophenolatevs Azathioprineyouth without LN
1.67(0.56–4.99)
Observational data: associations, not effects.
Further findings
≥1 hospitalised infection within 1 year of DMARD initiation (all, by LN status)
- All youths with cSLE
- 5%
- With LN
- 8%
- Without LN
- 2.5%
Higher oral corticosteroid dose (per 1 mg/day prednisone) and infection risk
- HR 1.1, 95% CI 1.05 to 1.15
Original publication
Association of disease-modifying antirheumatic drug selection with hospitalised infection among youth with childhood-onset systemic lupus erythematosus. Lupus Sci Med. Published 22 September 2025. doi:10.
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