Lupus & antiphospholipid syndrome
Outcomes following immunosuppressive therapy withdrawal after complete renal response in proliferative lupus nephritis
Authors' conclusion
Successful withdrawal of IST is possible in carefully selected patients with proliferative LN. If an RR occurs, most patients are able to remain in remission after resuming IST.
Study context
- Population
- Biopsy-confirmed proliferative lupus nephritis (LN) patients who received immunosuppressive therapy (IST) for at least 36 months and maintained complete renal response (CRR) for at least 12 months before IST discontinuation
- Participants
- 76 proliferative classes
- Outcome
- Renal relapse after IST withdrawal
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Relapse
29 patients
38.2%
Median time to relapse after IST withdrawal (IQR 9.25-63.5 months)
26.5 months
Severe relapses
9 cases
31%
Moderate relapses
16 cases
55.2%
Observational data: associations, not effects.
Further findings
Factors associated with risk of renal relapse
- IST discontinuation at ≤34 years of age (adjusted HR)
- 3.5
- IST duration >48 months before discontinuation (HR)
- 0.26
- CRR maintained ≥48 months (HR)
- 0.32
- Complete remission per DORIS at IST withdrawal (HR)
- 0.21
- Gradual IST tapering (HR)
- 0.09
Renal rebiopsy in relapsed patients
- Rebiopsy performed
- 25 (86.2%)
- Same histological class retained
- 80%
Response after IST reintroduction (n = 29 relapsed)
- CRR
- 20 out of 29 (68.9%)
- Partial response
- 5 (17.2%)
- No response
- 4 (13.8%)
- Progression to end-stage renal disease
- 3 patients (10.3%)
Median IST duration before discontinuation
- Median (IQR 53.5-120)
- 83.5 months
Original publication
Outcomes following immunosuppressive therapy withdrawal after complete renal response in proliferative lupus nephritis. Lupus Sci Med. Published 19 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →