Scholarlink

Background <p>To apply the 2025 EULAR prognostic factors to identify subgroups of patients with lupus nephritis (LN) in which triple therapy was associated with higher complete renal response (CR) rates.</p> Methods <p>We conducted a medical record review of patients with biopsy-proven class III, IV, or V LN who were treated at our hospital between 2000 and 2024. Multivariate logistic regression was used to identify EULAR 2025 prognostic factors independently associated with CR. Patients were stratified according to major prognostic factors and the cumulative burden of additional factors. Cumulative CR rates were compared, and Cox proportional hazards models were applied to evaluate the association between risk stratification and CR.</p> Results <p>Among the 170 patients included in this study, nephrotic-range proteinuria and a history of previous LN flare were negatively associated with CR (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.11–0.55, <i>p</i> &lt; 0.01 and OR 0.29, 95% CI 0.12–0.65, <i>p</i> &lt; 0.01, respectively). Using a stepwise risk stratification approach incorporating these factors and the cumulative number of remaining prognostic factors, patients were classified into low-, moderate-, and high-risk groups, showing a clear gradient in CR rates (94.0% vs. 71.8% vs. 40.9%, respectively, <i>p</i> &lt; 0.01). Using the high-risk group as the reference, the likelihood of achieving CR was substantially higher in the low- and moderate-risk groups (hazard ratio [HR] 22.8, 95% CI 8.27–81.24, p &lt; 0.01 and HR 3.7, 95% CI 1.53–9.52, <i>p</i> = 0.01). In the high-risk group, triple therapy remained independently associated with CR (adjusted HR 3.13, 95% CI 1.17–8.73, <i>p</i> = 0.02).</p> Conclusions <p>These findings suggest that baseline risk stratification identified subgroups in which triple therapy was associated with higher CR rates. Prospective validation in independent cohorts is required before this approach can inform treatment selection.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Early risk stratification in lupus nephritis based on established prognostic factors: association with outcomes under triple therapy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月31日

查看全文
  • Hironari Hanaoka,
  • Ryota Sakai,
  • Takumi Aoki,
  • Yuri Sasaki,
  • Taiji Kosaka,
  • Shoichi Yoshinaga,
  • Akiko Shibata,
  • Takahiko Kurasawa,
  • Koichi Amano

摘要

Background

To apply the 2025 EULAR prognostic factors to identify subgroups of patients with lupus nephritis (LN) in which triple therapy was associated with higher complete renal response (CR) rates.

Methods

We conducted a medical record review of patients with biopsy-proven class III, IV, or V LN who were treated at our hospital between 2000 and 2024. Multivariate logistic regression was used to identify EULAR 2025 prognostic factors independently associated with CR. Patients were stratified according to major prognostic factors and the cumulative burden of additional factors. Cumulative CR rates were compared, and Cox proportional hazards models were applied to evaluate the association between risk stratification and CR.

Results

Among the 170 patients included in this study, nephrotic-range proteinuria and a history of previous LN flare were negatively associated with CR (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.11–0.55, p < 0.01 and OR 0.29, 95% CI 0.12–0.65, p < 0.01, respectively). Using a stepwise risk stratification approach incorporating these factors and the cumulative number of remaining prognostic factors, patients were classified into low-, moderate-, and high-risk groups, showing a clear gradient in CR rates (94.0% vs. 71.8% vs. 40.9%, respectively, p < 0.01). Using the high-risk group as the reference, the likelihood of achieving CR was substantially higher in the low- and moderate-risk groups (hazard ratio [HR] 22.8, 95% CI 8.27–81.24, p < 0.01 and HR 3.7, 95% CI 1.53–9.52, p = 0.01). In the high-risk group, triple therapy remained independently associated with CR (adjusted HR 3.13, 95% CI 1.17–8.73, p = 0.02).

Conclusions

These findings suggest that baseline risk stratification identified subgroups in which triple therapy was associated with higher CR rates. Prospective validation in independent cohorts is required before this approach can inform treatment selection.