Lupus & antiphospholipid syndrome
The Renal Activity Index for Lupus: Validation for Prediction of Kidney Inflammation in Adult Patients With Lupus Nephritis
Authors' conclusion
RAIL scores identify active LN and longitudinally predict the course of adult LN.
Study context
- Population
- Adults with active biopsy-proven proliferative lupus nephritis (LN) in the ALLURE trial of abatacept599 samples
- Participants
- 240 adults
- Comparison
- Renal Activity Index for Lupus (RAIL) score vs urine protein/creatinine ratio (UPCR) and eGFR for discriminating renal response states
- Primary endpoint
- Accuracy of RAIL score (urine biomarker-derived) to capture and predict course of active LN
- Follow-up
- Up to week 52
Methodological detailsdouble-blind, randomized, serial urine samples up to week 52, mixed model analysis
- Double-blind
- Randomized
- Serial urine samples up to week 52
- Mixed model analysis
Primary result
As reported in the abstract
Discrimination of CRR from other renal response states
RAIL score, corrected for baseline UPCR and eGFR, current visit: AUC
0.83-0.84
RAIL score, corrected for baseline UPCR and eGFR, next visit: AUC
0.84-0.85
eGFR alone: poor accuracy to discriminate renal response, AUC
< 0.51
Further findings
| Outcome | CRR | PRR-only | NR |
|---|---|---|---|
| Patients by renal response state at weeks 12/24/52 | 27/33/18 events | 44/22/15 events | 127/61/15 events |
RAIL scores, eGFR and UPCR over time
- Improved over time irrespective of abatacept use, but significantly lower with complete renal response (CRR) compared to nonresponse (NR)
Original publication
The Renal Activity Index for Lupus: Validation for Prediction of Kidney Inflammation in Adult Patients With Lupus Nephritis. J Rheumatol. Published 15 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →