Lupus & antiphospholipid syndrome
Disease modification achievement in patients with lupus nephritis in a real-life setting: mission impossible?
Authors' conclusion
DM was achieved by only 60% of LN patients in a real-life setting, partly due to lack of glucocorticoids dose target attainment, while DM failure was associated with worse long-term renal outcomes.
Study context
- Population
- Biopsy-proven lupus nephritis (LN) patients (82% females) with ≥72 months follow-up at two joint academic centres82% females
- Exposure
- DM achievers vs non-achievers; diagnosis 1992–2005 vs 2006–2016
- Outcome
- DM achievement (all four criteria at all three time frames)
- Follow-up
- Month 72
Methodological detailstwo academic centres, ≥72 months follow-up, logistic regression
- Two academic centres
- ≥72 months follow-up
- Logistic regression
Main finding
As reported in the abstract
DM achievement
DM achieved
60%
DM achieved with GC excluded from DM criteria
70%
Observational data: associations, not effects.
Further findings
Predictor of DM achievement: 24-hour proteinuria at 9 months
| OR (95% CI) | P value | ||
|---|---|---|---|
| 24-hour proteinuria at 9 monthsNone of baseline characteristics predicted DM | 0.72 (0.53–0.97) | P = 0.03 | |
| 0.512Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| DM achievement by decade of diagnosisDiagnosed 1992–2005 vs Diagnosed 2006–2016 | P = 0.006 |
| DM achievement by decade of diagnosisDiagnosed 1992–2005 vs Diagnosed 2006–2016 | P < 0.01 |
- DM achievement by decade of diagnosis: significantly lower percentages of DM achievement in 1992–2005
- DM achievement by decade of diagnosis: GC dose reduction criterion met less often in all three time frames in 1992–2005
Long-term renal outcomes (flares, >30% proteinuria increase, estimated glomerular filtration rate (eGFR) decline) · end of follow-up (median 138 months)
- Non-achievers had worse renal outcomes than achievers
- Patients with >72 month follow-up
Original publication
Disease modification achievement in patients with lupus nephritis in a real-life setting: mission impossible? RMD Open. Published 12 June 2023. doi:10.
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