Lupus & antiphospholipid syndrome
Immunosuppressives discontinuation after renal response in lupus nephritis: predictors of flares, time to withdrawal and long-term outcomes
Authors' conclusion
Earlier CR achievement and lower SLEDAI-2K at tapering initiation prevent flares during IS tapering, while persistent hydroxychloroquine use and lower SLEDAI-2K 12 months before IS D/C prevent post-D/C flares. Flares during tapering increase the risk of unfavourable long-term outcomes. Earlier IS D/C is feasible in membranous LN.
Study context
- Population
- Inception cohort lupus nephritis (LN) patients
- Participants
- 137 patients
- Outcome
- Prevalence and predictors of IS tapering and discontinuation (D/C)
Methodological detailslogistic and linear regression models
- Logistic and linear regression models
Main finding
As reported in the abstract
Immunosuppressive (IS) tapering attempted
111
81%
D/C achieved
67.5%
Observational data: associations, not effects.
Further findings
Adverse outcomes (>30% eGFR decline, CKD, end-stage renal disease, death) by flares during IS tapering · end of follow-up (median 124 months)
P < 0.0038
| Outcome | β | P value |
|---|---|---|
| Time to D/C, membranous vs proliferative LND/C occurred 20 months earlier in membranous LN | −19.8 | P = 0.014 |
Predictors of renal flares during tapering
- Longer time to complete renal response (CR), OR
- 1.07, P = 0.046
- Higher SLEDAI-2K at tapering initiation, OR
- 2.57, P = 0.008
Predictors of post-D/C flares
- Persistent HCQ use (≥2/3 of follow-up), OR
- 0.28, P = 0.08
- SLEDAI-2K 12 months before IS D/C (lower decreased risk), OR
- 1.70, P = 0.013
Adverse outcomes (>30% eGFR decline, CKD, end-stage renal disease, death) by flares during IS tapering · end of follow-up (median 124 months)
- Did not differ between IS D/C achievers and non-achievers
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →