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Background <p>Lupus nephritis (LN) is a common and severe manifestation of systemic lupus erythematosus (SLE). We sought to evaluate treatment patterns, treat-to-target state attainment, and outcomes of patients with active LN on non-biologic, conventional therapy, in a large real-world cohort from the Asia–Pacific region.</p> Methods <p>Adult patients enrolled in a multinational lupus cohort were studied for evidence of active LN, defined based on the SLE Disease Activity Index-2000 (SLEDAI-2K)-proteinuria threshold (&gt; 0.5 g/24 h or &gt; 0.05g/mmol), ≥ 2 visits of data, and no exposure to biologics. The subset of these patients who had kidney biopsy-confirmed LN was retrospectively determined. Attainment of treatment goals, including modified versions of complete renal response (mCRR) and primary efficacy renal response (mPERR), lupus low disease activity state (LLDAS) and DORIS remission (REM), and organ damage accrual, were assessed over time following the first visit with proteinuria.</p> Results <p>One thousand one hundred eighty patients were studied for a median 2.7 [IQR 1.0, 5.0] years, 435 (37%) of whom had biopsies (Class III/IV = 242 (56%)). mCRR, mPERR, LLDAS, and REM were attained at least once during follow-up by 46%, 55%, 60%, and 46% of patients, respectively. mCRR and mPERR attainment was highest at year 2, while LLDAS and REM attainment gradually increased over time. New organ damage accrued in 11% of patients by year 1, increasing to 33% by year 5.</p> Conclusion <p>In a multinational cohort of patients with active LN receiving non-biologic conventional therapy, the attainment of renal responses, LLDAS, and REM was low, while damage accrual was prevalent.</p>

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Treatment patterns, treat-to-target goals and clinical outcomes of patients with active lupus nephritis: real-world evidence from a multicentre cohort study

  • 期刊论文

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  • 发表日期：

    2026年3月18日

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  • Joanna Kent,
  • Xiaomeng Xu,
  • Arushi Ramnarain,
  • Worawit Louthrenoo,
  • Vera Golder,
  • Laniyati Hamijoyo,
  • Shue-Fen Luo,
  • Yeong-Jian Jan Wu,
  • Yi-Hsing Chen,
  • Jiacai Cho,
  • Aisha Lateef,
  • Shirley Chan,
  • Chak Sing Lau,
  • Sandra Navarra,
  • Leonid Zamora,
  • Haihong Yao,
  • Sargunan Sockalingam,
  • BMDB Basnayake,
  • Yanjie Hao,
  • Zhuoli Zhang,
  • Madelynn Chan,
  • Chuanhui Xu,
  • Sang-Cheol Bae,
  • Yasuhiro Katsumata,
  • Jun Kikuchi,
  • Yuko Kaneko,
  • Tsutomu Takeuchi,
  • Shereen Oon,
  • Sean O’Neill,
  • Geraldine Hassett,
  • Fiona Goldblatt,
  • Yih Jia Poh,
  • Mark Sapsford,
  • Nicola Tugnet,
  • Kristine Pek Ling Ng,
  • Cherica Tee,
  • Michael Tee,
  • Yusuke Miyazaki,
  • Naoaki Ohkubo,
  • Yoshiya Tanaka,
  • Mandana Nikpour,
  • Alberta Hoi,
  • Aldo A Navarro Rojas,
  • Eric Morand,
  • Rangi Kandane-Rathnayake

摘要

Background

Lupus nephritis (LN) is a common and severe manifestation of systemic lupus erythematosus (SLE). We sought to evaluate treatment patterns, treat-to-target state attainment, and outcomes of patients with active LN on non-biologic, conventional therapy, in a large real-world cohort from the Asia–Pacific region.

Methods

Adult patients enrolled in a multinational lupus cohort were studied for evidence of active LN, defined based on the SLE Disease Activity Index-2000 (SLEDAI-2K)-proteinuria threshold (> 0.5 g/24 h or > 0.05g/mmol), ≥ 2 visits of data, and no exposure to biologics. The subset of these patients who had kidney biopsy-confirmed LN was retrospectively determined. Attainment of treatment goals, including modified versions of complete renal response (mCRR) and primary efficacy renal response (mPERR), lupus low disease activity state (LLDAS) and DORIS remission (REM), and organ damage accrual, were assessed over time following the first visit with proteinuria.

Results

One thousand one hundred eighty patients were studied for a median 2.7 [IQR 1.0, 5.0] years, 435 (37%) of whom had biopsies (Class III/IV = 242 (56%)). mCRR, mPERR, LLDAS, and REM were attained at least once during follow-up by 46%, 55%, 60%, and 46% of patients, respectively. mCRR and mPERR attainment was highest at year 2, while LLDAS and REM attainment gradually increased over time. New organ damage accrued in 11% of patients by year 1, increasing to 33% by year 5.

Conclusion

In a multinational cohort of patients with active LN receiving non-biologic conventional therapy, the attainment of renal responses, LLDAS, and REM was low, while damage accrual was prevalent.