Background
Methods
Patient population
Outcomes
Statistical analysis
Demographics (n = 180) | |
---|---|
Sex: female | 156 (86.7%) |
Age, mean (SD) | 35.2 (11.4) |
Ethnicity: Hispanic | 59 (32.7%) |
Race | |
Asian | 29 (16.1%) |
Black | 76 (42.2%) |
White | 53 (29.4%) |
Other/unknown | 22 (12.2%) |
First biopsy | 62 (34.0%) |
UPCR, mean [IQR] | 3.5 [1.60–4.38] |
Nephrotic proteinuria | 82 (45.6%) |
Serum creatinine mg/dL, mean [range] (n = 179) | 1.25 [0.4–7.4] |
High serum creatinine (n = 179)a | 46 (25.7%) |
Low C3 (n = 178)a | 116 (65.2%) |
Low C4 (n = 178)a | 102 (57.3%) |
Serum albumin g/dL, mean [range] (N = 171) | 3.1 [1.0–4.7] |
Positive anti-dsDNA (n = 176) | 124 (70.5%) |
Biopsy class | |
[III] | 30 (16.7%) |
[IV] | 35 (19.4%) |
[V] | 51 (28.3%) |
[III][IV] | 3 (1.7%) |
[III][V] | 36 (20.0%) |
[IV][V] | 25 (13.9%) |
Activity Index, mean [range] (n = 143) | 5.4 [0–18] |
Chronicity Index, mean [range] (n = 143) | 3.3 [0–10] |
Extra renal activity on hybrid SELENA-SLEDAIb | 87 (48.3%) |
Medicationsc | |
Hydroxychloroquine Daily average dose [range] | 137 (76.1%) 356.1 mg [85.7–800] |
Prednisone/methylprednisolone Daily average dose [range] Pulse steroids | 135 (75.0%) 24.4 mg [2.5–120] 21 (11.7%) |
Mycophenolate mofetil Daily average dose [range] Mycophenolic acid Daily average dose [range] | 116 (6.44%) 2435.3 mg [500–3000] 8 (4.4%) 1215 mg [360–2880] |
Cyclophosphamide | 24 (13.3%) |
Azathioprine | 6 (3.3%) |
Tacrolimus | 19 (10.6%) |
Belimumab | 4 (2.2%) |
Leflunomide | 1 (0.6%) |
Results
Baseline characteristics
Longitudinal patterns of response
% Response at both visits | % Non-response at both visits | % Discordant response status | Kappa (95% CI) for agreement in response status across visits | |
---|---|---|---|---|
Week 12 and week 26 | 20.8% | 51.5% | 27.7% | 0.41 (0.27, 0.56) |
Week 12 and week 52 | 16.5% | 40.9% | 42.5% | 0.16 (0.015, 0.30) |
Week 26 and week 52 | 33.8% | 33.8% | 32.4% | 0.36 (0.21, 0.51) |
Patient characteristics associated with persistent responses at weeks 26 and 52
Predictor variable | Odds ratio estimate (95% confidence interval) | P value |
---|---|---|
First biopsy | 3.12 (0.89–10.89) | 0.075 |
Anti-dsDNA antibody positive | 4.70 (1.19–18.51) | 0.027 |
No Cyclophosphamide induction | 5.08 (0.80–32.26) | 0.084 |
UPCR > 25% decrease from baseline to week 12 | 7.37 (2.31–23.49) | < 0.001 |
Patient characteristics associated with response at week 52
Predictor variable | Odds ratio estimate (95% confidence interval) | P value |
---|---|---|
Anti-dsDNA antibody positive | 2.61 (0.93–7.33) | 0.069 |
UPCR > 25% decrease from baseline to week 12 | 2.61 (1.07–6.41) | 0.036 |
Chronicity Index per unit decrease | 1.33 (1.10–1.62) | 0.003 |
UPCR > 3 at baseline | 3.71 (1.34–10.24) | 0.012 |