Lupus & antiphospholipid syndrome
Comparable 12-month renal response outcomes with medium- vs high-dose starting prednisone in a real-world study of Lupus Nephritis
Authors' conclusion
Despite significantly increasing GC exposure, a higher starting prednisone dose was not associated with improved renal response rates at 12 months in a contemporary LN cohort.
Study context
- Population
- Patients with new-onset biopsy-proven LN, 2014 to date
- Participants
- 162 patients
- Exposure
- High vs low-medium starting prednisone dose
- High dosen = 61
- Low-medium dosen = 101reference
- Outcome
- Complete renal response (CRR)
- Follow-up
- 12 months
Methodological detailsmulticentre, inverse probability of treatment weighting, multivariable regression, time-to-response analyses
- Multicentre
- Inverse probability of treatment weighting
- Multivariable regression
- Time-to-response analyses
Main finding
As reported in the abstract
12-month CRR
P = 0.55
- Higher initial prednisone dose not associated with better complete renal response (CRR) rate (multivariable logistic regression with inverse probability of treatment weighting (IPTW)), adjusted OR
- 1.00 (95% CI: 0.46-2.22)
Observational data: associations, not effects.
Further findings
Cumulative prednisone exposure in the first year
P < 0.001
- Time to overall renal response
- log-rank P = 0.26
Cumulative prednisone exposure in the first year
- Cumulative doses equalized by years 2 and 3
Time to overall renal response
- No difference in achieving overall renal response
Original publication
Comparable 12-month renal response outcomes with medium- vs high-dose starting prednisone in a real-world study of Lupus Nephritis. Rheumatology (Oxford). Published 30 October 2025. doi:10.
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