TY - JOUR
T1 - Assessment of long-term remission in lupus nephritis patients
T2 - A retrospective analysis over 30 years
AU - Fernandes das Neves, Marisa
AU - Irlapati, Rajendra Vara Prasad
AU - Isenberg, David
N1 - Publisher Copyright:
© The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
PY - 2015/5/5
Y1 - 2015/5/5
N2 - Objective. To review the likelihood of very long-term remission in patients with biopsy-proven LN attempting to identify good prognostic features. Methods. We reviewed patients with LN whose renal biopsies showed World Health Organization (WHO) classes III, IV and V and who had a follow-up of at least 5 years between 1973 and 2008. We analysed demographic, clinical, laboratory and therapeutic parameters comparing those patients with (group A) and without (group B) 5 year remission. Results. Of 191 LN patients followed, 105 patients met the strict inclusion criteria. Ninety-five patients were female. Mean age at diagnosis of lupus was 24.1 years (s.d. 10.7). ean age at diagnosis of LN was 28.4 years (s.d. 11.3). The mean duration of follow-up was 13.7 years (s.d. 14.1). Forty (38%) patients achieved 5 year remission, of whom 17 (16.2%) had remission for ≥15 years. The incidence of flares per year from 5 to 15 years was 7.9%; however, no flares were observed after 15 years of remission. The only distinguishing feature found in this study was the association of WHO class IV on kidney biopsy with LN progression (P = 0.03).Conclusion. Renal histology with WHO class IV predicted a poor long-term remission rate. Age, sex, ethnicity, serological parameters and treatment received did not predict long-term remission. Renal flares can occur up to 15 years after a patient has gone into remission.
AB - Objective. To review the likelihood of very long-term remission in patients with biopsy-proven LN attempting to identify good prognostic features. Methods. We reviewed patients with LN whose renal biopsies showed World Health Organization (WHO) classes III, IV and V and who had a follow-up of at least 5 years between 1973 and 2008. We analysed demographic, clinical, laboratory and therapeutic parameters comparing those patients with (group A) and without (group B) 5 year remission. Results. Of 191 LN patients followed, 105 patients met the strict inclusion criteria. Ninety-five patients were female. Mean age at diagnosis of lupus was 24.1 years (s.d. 10.7). ean age at diagnosis of LN was 28.4 years (s.d. 11.3). The mean duration of follow-up was 13.7 years (s.d. 14.1). Forty (38%) patients achieved 5 year remission, of whom 17 (16.2%) had remission for ≥15 years. The incidence of flares per year from 5 to 15 years was 7.9%; however, no flares were observed after 15 years of remission. The only distinguishing feature found in this study was the association of WHO class IV on kidney biopsy with LN progression (P = 0.03).Conclusion. Renal histology with WHO class IV predicted a poor long-term remission rate. Age, sex, ethnicity, serological parameters and treatment received did not predict long-term remission. Renal flares can occur up to 15 years after a patient has gone into remission.
KW - Lupus flares
KW - Lupus remission
KW - Renal biopsy in lupus
KW - Systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=84939503732&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/kev003
DO - 10.1093/rheumatology/kev003
M3 - Article
C2 - 25725362
AN - SCOPUS:84939503732
SN - 1462-0324
VL - 54
SP - 1403
EP - 1407
JO - Rheumatology (United Kingdom)
JF - Rheumatology (United Kingdom)
IS - 8
ER -