What question did this study set out to answer?

To describe different clinical phenotypes of severe flares in systemic lupus erythematosus (SLE) patients and compare treatment and outcomes.

November 21, 2025Frontiers in ImmunologyOpen Access

Different phenotypes of severe flares in patients with systemic lupus erythematosus: results of a clustering analysis in a monocentric cohort

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Clustering analysis identifies different flare phenotypes in systemic lupus erythematosus, suggesting implications for treatment outcomes.

To describe different clinical phenotypes of severe flares in systemic lupus erythematosus (SLE) patients and compare treatment and outcomes.
Retrospective study of 122 severe flares in 110 SLE patients from 2018 to 2023.
Used SELENA-SLEDAI and BILAG 2004 scores for disease activity assessment.
Applied a hierarchical unsupervised segmentation method for clustering flares based on baseline features.
Identified three clusters of severe flares: two non-renal and one renal.
Non-renal cluster 1 showed severe symptoms, hyper-inflammatory biomarkers, while cluster 2 had mucocutaneous manifestations and antiphospholipid syndrome.
Clusters treated with glucocorticoid pulses and mycophenolate mofetil exhibited comparable treatment response rates to renal flares.

Elefante et al. (2025) studied this question.

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Clustering analysis identifies different flare phenotypes in systemic lupus erythematosus, suggesting implications for treatment outcomes.