Lupus & antiphospholipid syndrome
Are RAS inhibitors necessary during intensive immunosuppression for lupus nephritis? Real-world evidence from the STAR cohort
Authors' conclusion
Adding RASi to standard induction therapy provided no additive benefit for renal remission or proteinuria reduction within the first 12 months nor did it facilitate glucocorticoid tapering.
Study context
- Population
- Patients with lupus nephritis (LN) receiving standard induction therapy, STAR (Treat-SLE-to-Target) registry
- Participants
- 314 patients
- Exposure
- Renin-angiotensin system inhibitors (RASi) added to standard induction therapy vs no RASi
- RASin = 220
- non-RASin = 94reference
- Outcome
- CRR
- Follow-up
- 12 months
Methodological detailspropensity score overlap weighting, registry-based (STAR)
- Propensity score overlap weighting
- Registry-based (STAR)
Main finding
As reported in the abstract
CRR, weighted analysis
- No significant difference in complete renal remission (CRR) at 12 months (58.7% vs 64.7%)
- RASi vs non-RASi: P = 0.428
- Propensity score overlap weighting
Observational data: associations, not effects.
Secondary outcomes
TRR, weighted analysis · 6 months · significantly lower in RASi
P = 0.026
- CRR, weighted analysis · 6 months · no significant difference · propensity score overlap weighting
- P = 0.169
CRR, weighted analysis · 6 months
- No significant difference in CRR at 6 months (43.1% vs 53.4%)
Proteinuria % reduction, GC tapering, disease activity decline
- Proteinuria percentage reduction comparable between groups
- RASi use not associated with accelerated GC tapering or more rapid decline in disease activity
Independent predictors of CRR (multivariable analysis)
- LN at SLE onset and baseline pyuria independent predictors of CRR; RASi usage not
Original publication
Are RAS inhibitors necessary during intensive immunosuppression for lupus nephritis? Real-world evidence from the STAR cohort. Lupus Sci Med. Published 30 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →