Lupus & antiphospholipid syndrome
Antimalarial use and extra-renal damage accrual in lupus nephritis: a longitudinal cohort study
Main finding · Extra-renal damage accrualResult — go to the resultHazard ratio 0.51 95% CI 0.37–0.72Authors' conclusion
In this population, antimalarial therapy was associated with a significant protective effect against extra-renal damage.
Study context
- Population
- Patients with biopsy-confirmed lupus nephritis (LN), University of Toronto Lupus Clinic (1970–2024); median age 34.1 years, 14.5% male327 with complete SLICC/ACR Damage Index (SDI) data
- Participants
- 352 patients
- Exposure
- Antimalarial use vs no antimalarial use
- Outcome
- Extra-renal damage accrual: any increase (≥1) in extra-renal SLICC/ACR DI (SDI)
Methodological detailstime-dependent exposure, multivariable Cox proportional hazards models, single-centre, Median follow-up 9.6 years [IQR 4.9-16.6]
- Time-dependent exposure
- Multivariable Cox proportional hazards models
- Single-centre
- Median follow-up 9.6 years [IQR 4.9-16.6]
Main finding
Extra-renal damage accrual
Hazard ratio
0.51
95% CI 0.37–0.72
Antimalarial usevs No antimalarial use
HR 0.51 (95% CI 0.37–0.72)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Extra-renal damage (all patients with complete SDI data)
- Patients with extra-renal damage
- 151 (46.2%)
- Median time to extra-renal damage, years [IQR]
- 4.1 [1.8-8.9]
Extra-renal damage by baseline extra-renal SDI subgroup (SDI = 0 and SDI ≥1)
- Protective effect remained significant across all baseline extra-renal SDI subgroups
Antimalarial use over time
- Baseline
- 47.7%
- First year
- 58.5%
- By year 5
- 67.9%
Original publication
Antimalarial use and extra-renal damage accrual in lupus nephritis: a longitudinal cohort study. Rheumatology (Oxford). Published 4 April 2026. doi:10.
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