To explore recent temporal trends in pediatric systemic lupus erythematosus (SLE) in Beijing.

Electronic health record data were extracted from the Beijing Hospital Quality Monitoring System and the Beijing Electronic Medical Record Sharing Project (30 pilot hospitals). Changes in epidemiology, clinical characteristics, and treatment patterns were analyzed for the period June 2015 to May 2023.

A total of 4197 pediatric SLE patients were included, of whom 874 (20.82%) were male. Among 3361 children with disease onset after May 31, 2016, the median age at onset was 12 years. From 2016 to 2022, the incidence of SLE among children aged 0-14 years in Beijing increased from 2.91 to 6.02 per 100000. From 2015 to 2022, the incidence of renal (RR=1.02) and hematologic (RR=1.16) damage in hospitalized children showed a significant upward trend (P<0.05). Over the same period, cyclophosphamide use declined from 59.8% to 29.0% (P<0.05), while the use of hydroxychloroquine (RR=1.09), mycophenolate mofetil (RR=1.11), and tacrolimus (RR=1.29) increased significantly (P<0.05).

In Beijing, data from 2015-2022 indicate a rising incidence of pediatric SLE, an increasing burden of organ damage among hospitalized patients, and marked shifts in treatment patterns.