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Systemic lupus erythematosus shows distinct sex-based clinical and treatment patterns.  

Researchers conducted a retrospective study published in June 2025 issue of  Rheumatology International to compile evidence on sex-specific differences in systemic lupus erythematosus (SLE), focusing on autoantibodies, organ involvement, damage, treatment, and patient-reported outcomes (PROs).  

They performed systematic searches in PubMed and the Cochrane Library, covering studies from January 2015 to November 2024. Meta-analyses, observational studies, and clinical trials were included. Eligible studies involved adults diagnosed with SLE and reported outcomes stratified by sex. The study protocol was registered in the Registry for Scoping Reviews [OSF, https://osf.io/gfbs9].  

The results showed that males had a higher age at onset of SLE and a greater frequency of lupus anticoagulant, nephritis, serositis, antiphospholipid syndrome, severe infections, and renal and cardiovascular damage. In contrast, SLE in females was more often linked to Ro/SSA autoantibodies, photosensitivity, Raynaud phenomenon, alopecia, and osteoporosis. Cyclophosphamide use appeared more common in males, while antimalarial use was less frequent. Limited findings suggested greater non-adherence to azathioprine and mycophenolate in females. Data on PROs remained scarce.  

Investigators concluded that SLE differed notably by sex, with men experiencing later onset and more severe organ damage, and women showing distinct clinical features and treatment patterns, while evidence on PROs remained limited. 

Source: link.springer.com/article/10.1007/s00296-025-05910-7