Lupus & antiphospholipid syndrome
Clinical and immunological outcomes of rituximab-based, mycophenolate mofetil-based and cyclophosphamide-based treatment strategies for systemic lupus erythematosus with active kidney involvement from LOOPS registry
Authors' conclusion
The 52-week clinical effectiveness of the RTX-based, MMF-based and IVCY-based strategies for active lupus nephritis did not differ significantly. Different within-strategy immunophenotypic patterns were observed, but between-strategy differences were not confirmed.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) and active LN enrolled in the LOOPS registry
- Exposure
- Rituximab (RTX)-based vs mycophenolate mofetil (MMF)-based vs intravenous cyclophosphamide (IVCY)-based induction strategies, each with glucocorticoids (GCs)
- Outcome
- Co-primary: achievement rates of complete renal response (CRR) and urinary protein-to-creatinine ratio <0.7 g/gCr
- Follow-up
- Week 52
Methodological detailsregistry-based (LOOPS registry)
- Registry-based (LOOPS registry)
Main finding
As reported in the abstract
CRR rates and improvement in proteinuria
- No significant differences in complete renal response (CRR) rates or improvement in proteinuria among the groups
Observational data: associations, not effects.
Secondary outcomes
Changes in eGFR, disease activity measures and concomitant GC dose · week 52
- Did not differ significantly
Peripheral blood immunophenotypic changes (exploratory within-strategy analyses)
- Reduced B-cell subset proportions with RTX; broader reductions, including in activated T cells, with MMF and IVCY
- Treatment strategy-by-time interaction not significant; no evidence of between-strategy differences in longitudinal changes
- Exploratory
Original publication
Clinical and immunological outcomes of rituximab-based, mycophenolate mofetil-based and cyclophosphamide-based treatment strategies for systemic lupus erythematosus with active kidney involvement from LOOPS registry. RMD Open. Published 25 September 2026. doi:10.
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