Your browser doesn't support javascript.
loading
Lupus Nephritis Outcomes after Stopping Immunosuppression.
Alenzi, Fahidah; Ateka-Barrutia, Oier; Ken Cheah, Chee; Khamashta, Munther; Sangle, Shirish R; D'Cruz, David P.
Afiliación
  • Alenzi F; Internal Medicine Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia.
  • Ateka-Barrutia O; Internal Medicine Department, Donostia University Hospital, 20014 Donostia, Spain.
  • Ken Cheah C; Louise Coote Lupus Unit, Counting House, Guy's Hospital, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, London SE1 9RT, UK.
  • Khamashta M; Louise Coote Lupus Unit, Counting House, Guy's Hospital, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, London SE1 9RT, UK.
  • Sangle SR; Louise Coote Lupus Unit, Counting House, Guy's Hospital, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, London SE1 9RT, UK.
  • D'Cruz DP; Louise Coote Lupus Unit, Counting House, Guy's Hospital, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, London SE1 9RT, UK.
J Clin Med ; 13(8)2024 Apr 11.
Article en En | MEDLINE | ID: mdl-38673484
ABSTRACT
Background/

Objectives:

Immunosuppression (IS) is a standard therapy for lupus nephritis (LN). Data on the outcomes of patients with LN after the discontinuation of immunosuppression remain uncertain. This study aimed to evaluate the outcomes and results of patients with lupus nephritis (LN) who ceased immunosuppressive (IS) therapy.

Methods:

Records were obtained on the clinical and laboratory features of LN patients who were treated at our Lupus Unit. They included median values and ranges for various numerical variables such as patient age, disease duration, and treatment duration. Categorical variables such as gender, LN class, IS treatment type, and patient outcomes, which were categorized as either "stable" or "flare experienced", were presented as percentages and frequencies. A flare in LN was characterized by a two-fold increase in serum creatinine levels and a rise in proteinuria following the cessation of IS medication.

Results:

Outcomes were assessed for 45 patients with LN who ceased IS therapy after achieving remission. The patients' median age was 55 years (29-78). The median duration of treatment was 4 years (0.5-14). The LN histology distribution was class V = 24.4%, class IV = 17.8 %, class III = 17.8%, class III + IV = 15.6%, class III + V = 6.7%, class IV + V = 2.2%, and class II + IV and II = 2.2%. At the discontinuation of IS treatment, creatinine levels were elevated in 9/45 (20%) patients. Furthermore, 28.9% of patients relapsed after IS treatment discontinuation. Patients with anti-Smith antibodies (anti-Sm) were observed to have a higher occurrence of relapses, with six patients experiencing flare compared to four patients who remained stable (p = 0.03). Five (38.5%) of the patients with flares had high creatinine levels after IS discontinuation.

Conclusions:

Most of our patients maintained clinical remission and stable levels of LN parameters after IS treatment discontinuation. Those with a high serum creatinine level, ongoing proteinuria, depleted complement levels, and the presence of anti-Sm antibodies were more likely to experience flares after the discontinuation of IS therapy.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Arabia Saudita Pais de publicación: Suiza