Lupus & antiphospholipid syndrome
Effect of ethnicity on response to treatment escalation in patients with systemic lupus erythematosus from the British Isles Lupus Assessment Group Biologics Register (BILAG-BR): a longitudinal cohort study
Main finding · Major clinical response (MCR)Result — go to the resultOdds ratio 0.13 95% CI 0.02–0.88Authors' conclusion
MCR criteria were met by fewer than a quarter of patients after treatment escalation. Patients of Black ethnicity had higher baseline disease burden and lower observed response than White patients. These results support the need for more personalised, equitable approaches to SLE management and reinforce the importance of ensuring diversity in clinical research.
Study context
- Population
- Patients aged 16 years and older with active moderate-to-severe systemic lupus erythematosus (SLE) who had initiated rituximab or belimumab within the past 12 months, or standard immunosuppressive therapy within the past 1 month, from the British Isles Lupus Assessment Group Biologics Register (BILAG-BR), 64 UK secondary and tertiary rheumatology and nephrology centrespatients included in the study, of 1688 recruited to the BILAG-BR (1266 excluded), 383 (91%) female, 39 (9%) male, median age 40.5 years (IQR 31.3–50.8)
- Participants
- 422 patients
- Exposure
- Ethnic groups compared with White patients
- Whiten = 245reference
- South Asiann = 77
- Blackn = 70
- East Asiann = 19
- Mixed or other ethnicitiesn = 11
- Outcome
- major clinical response (MCR)
- Follow-up
- 12 months
Methodological detailsmixed-effects logistic regression, Individuals with lived experience of SLE were involved in the study design
- Mixed-effects logistic regression
- Individuals with lived experience of SLE were involved in the study design
Main finding
As reported in the abstract
Odds ratio
0.13
95% CI 0.02–0.88
Events by group
Blackvs White
OR 0.13 (95% CI 0.02–0.88)
- All patients meeting major clinical response (MCR) criteria
- 99 (23%) of 422
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Black patients had higher baseline disease activity, greater organ damage, and more comorbidities
Original publication
Effect of ethnicity on response to treatment escalation in patients with systemic lupus erythematosus from the British Isles Lupus Assessment Group Biologics Register (BILAG-BR): a longitudinal cohort study. Lancet Rheumatol. Published 2 November 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →