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Study: Class 5 lupus individually associated with renal response
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WASHINGTON — Concomitant class 5 lupus nephritis, along with a lower urine protein to creatinine ratio at baseline, were individually associated with complete renal response in patients with lupus, according to data presented at the American College of Rheumatology Annual Meeting.
Matthew D. Cascino, MD, clinical fellow at the University of California, San Francisco, and colleagues evaluated a phase 3 trial of 146 patients. Of these patients, 26% had concomitant class 5 lupus. Patients received either mycophenolate mofetil (85%) or a Euro-Lupus cyclophosphamide regimen (15%) plus placebo. At baseline, the mean urine protein to creatinine ratio (UPCR) was 4.1 and the mean estimated globular filtration rate was 87 mL/min/1.73m2. After 1 year, the researchers assessed renal response, which they separated into three categories: complete; partial; and nonresponse. They defined complete renal response (CRR) as a UPCR of less than 0.5 and serum creatinine level 25% above baseline. They defined a partial renal response (PRR) as a 50% reduction in UPCR, a UPCR reduction to less than 3 if the screening value was greater than 3, as well as a serum creatinine level 25% above baseline; and nonresponse was defined as no CRR or PRR. Using multivariate logistic regression, the researchers evaluated the association between each variable and renal response.
Researchers found CRR was individually associated with both class 5 lupus (odds ratio = 2.8) and a lower UPCR at baseline (odds ratio = 1.18 per 1-unit decrease). In addition, a decreased likelihood of nonresponse was associated with a 25% reduction in UPCR at week 8 (odds ratio = 0.33) and class 5 lupus (odds ratio = 0.32).
“These findings may allow for the prospective identification of patients more or less likely to achieve renal response using a conventional definition of renal outcome in clinical trials,” Cascino said in his presentation. “This may facilitate the identification of new therapies for lupus nephritis.” – by Will Offit
Reference:
Cascino MD, et al. Abstract #965. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.
Disclosures: Cascino reports he is an employee at Genentech Inc. Please see the full abstract for a list of all other relevant financial disclosures.