Publication Name	World Journal of Clinical Pediatrics
Manuscript ID	127054
DOI	10.5409/wjcp.127054
Country	Egypt

Category	Pediatrics
Manuscript Type	Meta-Analysis
Article Title	Comparative efficacy and safety of mycophenolate mofetil vs cyclophosphamide for induction therapy in childhood-onset lupus nephritis: Updated meta-analysis
Manuscript Source	Invited Manuscript
All Author List	Muhammad Husnain Mumtaz, Aliza Arif, Eman S Sawan, Ayesha Nawal, Pari Kotak, Ali Hassan, Basil Joy, Aiman Amir, Andreea Lescaie, Fahad Amin, Maryam Imran Sheikh, Humna Shahid, Iqra Nadeem, Ebrahim Alkashlan and Khaled Saad
Funding Agency and Grant Number
Corresponding Author	Khaled Saad, Chief Physician, Consultant, Full Professor, MD, PhD, Principal Investigator, Researcher, Senior Scientist, Department of Pediatrics, Neuro-Pediatrics, Assiut University, Assiut 71516, Upper Egypt, Egypt. khaled.ali@med.au.edu.eg
Key Words	Childhood-onset lupus nephritis; Systemic lupus erythematosus; Mycophenolate mofetil; Cyclophosphamide; Pediatric nephrology; Meta-analysis; Systematic review
Core Tip	This updated meta-analysis of 14 comparative studies (two randomized trials and 12 observational studies) found no statistically significant differences between mycophenolate mofetil and cyclophosphamide for induction outcomes in childhood-onset lupus nephritis, including complete remission, partial and total renal response, mortality, infections, and adverse events. However, the combined estimates across randomized and observational studies were exploratory, and the observational evidence was at serious risk of bias, principally because of confounding by indication. The overall certainty of evidence was very low; therefore, these findings do not establish equivalence, non-inferiority, comparable survival, or comparable long-term safety. Treatment selection should remain individualized based on disease severity, histopathologic class, and long-term safety considerations.
Citation	Mumtaz MH, Arif A, Sawan ES, Nawal A, Kotak P, Hassan A, Joy B, Amir A, Lescaie A, Amin F, Sheikh MI, Shahid H, Nadeem I, Alkashlan E, Saad K. Comparative efficacy and safety of mycophenolate mofetil vs cyclophosphamide for induction therapy in childhood-onset lupus nephritis: Updated meta-analysis. World J Clin Pediatr 2026; In press DOI: https://doi.org/10.5409/wjcp.127054
PDF	127054-in-press.pdf

Received	2026-08-20 07:25
Peer-Review Started	2026-08-20 07:25
First Decision by Editorial Office Director
Return for Revision	2026-09-03 02:46
Revised	2026-09-15 20:32
Publication Fee Transferred
Second Decision by Editor	2026-11-05 02:36
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-11-05 09:06
Articles in Press	2026-11-05 09:06
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2219-2808 (online)
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