Lupus & antiphospholipid syndrome
Immunosuppressive therapy withdrawal in lupus nephritis, is it possible?: A systematic review
Authors' conclusion
IST withdrawal is feasible in patients with LN who have achieved remission, but careful monitoring is required due to the risk of relapse and potential progression of chronic kidney damage.
Study context
- Population
- Patients with proliferative lupus nephritis (LN) in remission for at least 1 year who discontinued IST
- Participants
- 310 patients5 studies
- Comparison
- Flare vs no flare after IST withdrawal
- Outcome
- Flare following IST withdrawal
Methodological detailsrisk of bias assessed with Newcastle-Ottawa Scale and JADAD Score, Lupus duration before entry ≈4-10 years; complete remission 12-59.5 months before IST withdrawal; mean age 26 to 38 years
- Risk of bias assessed with Newcastle-Ottawa Scale and JADAD Score
- Lupus duration before entry ≈4-10 years; complete remission 12-59.5 months before IST withdrawal; mean age 26 to 38 years
Pooled result
As reported in the abstract
Flares following IST withdrawal · Follow-up 24 to 215 months
Average proportion of patients with flare
28.7%
Further pooled results
Baseline characteristics, flare vs no-flare
- Baseline serum creatinine comparable
- Baseline proteinuria and C3 & C4 levels varied across studies
- Biopsy Activity and Chronicity Index varied but generally higher chronic damage in flare group
Original publication
Immunosuppressive therapy withdrawal in lupus nephritis, is it possible?: A systematic review. Lupus. Published 17 June 2025. doi:10.
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