Evaluation of remission of lupus nephritis in patients aged 18 to 45 years with induction immunosuppressive treatment.

A single-center observational study.

Abstract

Introduction: Lupus nephritis (LN) occurs in 50% of patients with Systemic Lupus Erythematosus. The standard of induction treatment consists of Corticosteroids plus immunosuppressants such as Cyclophosphamide or Mycophenolate Mofetil (MMF). Achieving remission correlates with long-term renal survival. The objective of the present study was to evaluate the remission of LN in patients aged 18 to 45 years with induction immunosuppressive treatment to assess the effectiveness of Cyclophosphamide and MMF.

Methods: a retrospective analytical observational cohort study was carried out at the Eugenio Espejo Specialty Hospital; there were “n” = 185 patients with LN, of which 68 met the inclusion criteria. The selected variables were sex, ethnicity, age at diagnosis of lupus and LN, antiphospholipid syndrome (APS) antibodies, SLEDAI-2K, HBP, ISN/RPS Class, induction immunosuppressant, clinical remission and reactivation, descriptive tests were performed and inferential tests with statistical significance of P < 0.05 in the SPSS version 25 program.

Results: 68 cases are analyzed. LN was more frequent in women (95.6%), of mixed ethnicity (97.1%), with a mean age of diagnosis of Lupus of 27.7 ± 8.1 years and of LN of 28.8 years ± 9.3 years; 16.2% presented positive antibodies for APS, 63.2% presented HTN at diagnosis. The majority were LN Class IV, according to renal biopsy. At 3.6 and 12 months, no difference was found in remission and reactivation between the Cyclophosphamide and MMF groups (P<0.05).

Conclusion: The efficacy of MMF is comparable to that of Cyclophosphamide in terms of remission and reactivation in our population.