Lupus & antiphospholipid syndrome
Attainment of EULAR/ERA-EDTA targets of therapy with current immunosuppressive regimens and adjustments in treatment: a multicentre, real-life observational study
Authors' conclusion
More than two-thirds of patients with LN attain EULAR/ERA-EDTA response rates by 12 months, but 20% require therapy modifications within this time period. Patients with increased chronicity in baseline biopsy, when combined with histological activity, are at higher risk for a lack of clinical response.
Study context
- Population
- Patients with new-onset lupus nephritis (LN) (2014 to date) managed with conventional immunosuppressive therapies120 with data at 12 months
- Participants
- 140 patients
- Outcome
- EULAR/ERA-EDTA renal response rates in the first year; determinants of failure to respond at 12 months
- Follow-up
- 12 months
Methodological detailsmulticentre, real-life observational, Initial treatment: cyclophosphamide in 51.4% (84.7% high-dose, 15.3% low-dose), mycophenolate in 32.1%
- Multicentre
- Real-life observational
- Initial treatment: cyclophosphamide in 51.4% (84.7% high-dose, 15.3% low-dose), mycophenolate in 32.1%
Main finding
As reported in the abstract
Renal response at 12 months
69.2%
Increased Chronicity Index at baseline associated with failure to achieve complete or partial response at 12 months (multivariate), OR 2.26, 95% CI
1.35 to 3.77
Observational data: associations, not effects.
Further findings
Predictor of failure to achieve complete or partial renal response: increased Chronicity Index at baseline (multivariate analysis) · 12 months
- OR for failure to respond per increased Chronicity Index
- OR 2.26, 95% CI 1.35 to 3.77
- Multivariate analysis
Treatment modifications due to suboptimal response · first 12 months
- Patients requiring treatment modifications
- 20%
- Addition of a different immunosuppressive drug (patients)
- seven
- Switch to a different immunosuppressive drug (patients)
- nine
Original publication
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