To Örebro University

oru.seÖrebro University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Predictors of renal flares in systemic lupus erythematosus: a post-hoc analysis of four phase III clinical trials of belimumab
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Division of Rheumatology, Danderyd University Hospital, Danderyd, Sweden.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-4875-5395
2024 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, article id keae023Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: To identify predictors of renal flares in patients with SLE treated for active extra-renal disease.

METHODS: Data from four clinical trials of belimumab in SLE (BLISS-52, NCT00424476; BLISS-76, NCT00410384; BLISS-NEA, NCT01345253; BLISS-SC, NCT01484496) were used. Patients were assigned to belimumab or placebo on top of standard therapy. We investigated the performance of predictors of renal flares through 52-76 weeks using proportional hazards regression analysis.

RESULTS: Of 3225 participants, 192 developed at least one renal flare during follow-up, with the first occurring after a median time of 197 days. Current/former renal involvement (HR: 15.4; 95% CI: 8.3-28.2; p< 0.001), low serum albumin levels (HR 0.9; 95% CI: 0.8-0.9; p< 0.001), proteinuria (HR: 1.6; 95% CI: 1.5-1.7; p< 0.001), and low C3 levels (HR: 2.9; 95% CI: 2.1-4.1; p< 0.001) at baseline appeared robust determinants of renal flares. Anti-dsDNA positivity yielded an increased hazard for renal flares (HR: 2.1; 95% CI: 1.4-3.2; p< 0.001), which attenuated after adjustments. Anti-Sm positivity was associated with renal flares in the placebo (HR: 3.7; 95% CI: 2.0-6.9; p< 0.001) but not in the belimumab subgroup, whereas anti-ribosomal P positivity was associated with renal flares in the belimumab subgroup only (HR: 2.8; 95% CI: 1.5-5.0; p= 0.001).

CONCLUSION: A history of renal involvement, high baseline proteinuria, hypoalbuminaemia, and C3 consumption were robust determinants of impending renal flares. Beyond anti-dsDNA, anti-Sm and anti-ribosomal P protein antibody positivity may have value in surveillance of renal SLE.

Place, publisher, year, edition, pages
Oxford University Press, 2024. article id keae023
Keywords [en]
Belimumab, biologics, biomarkers, renal flares, systemic lupus erythematosus
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:oru:diva-110707DOI: 10.1093/rheumatology/keae023ISI: 001155690700001PubMedID: 38216728OAI: oai:DiVA.org:oru-110707DiVA, id: diva2:1827609
Funder
AstraZenecaEli Lilly and CompanySwedish Rheumatism Association, R-98222King Gustaf V Jubilee Fund, FAI-2020–0741]Swedish Society of Medicine, SLS-974449Nyckelfonden, OLL-974804Region Stockholm, FoUI-955483Karolinska Institute
Note

This work was supported by grants from the Swedish Rheumatism Association [R-982223]; the King Gustaf V’s 80-year Foundation [FAI-2020–0741]; the Swedish Society of Medicine [SLS-974449]; Nyckelfonden [OLL-974804]; the Professor Nanna Svartz Foundation [2020–00368]; the Ulla and Roland Gustafsson Foundation [2023–35]; the Region Stockholm [FoUI-955483]; and the Karolinska Institutet.

Disclosure statement: I.P. has received research funding and/or honoraria from Amgen, AstraZeneca, Aurinia, Bristol-Myers Squibb, Elli Lilly, Gilead, GlaxoSmithKline, Janssen ,Novartis, Otsuka, and Roche. 

Available from: 2024-01-15 Created: 2024-01-15 Last updated: 2024-02-14Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records

Parodis, Ioannis

Search in DiVA

By author/editor
Parodis, Ioannis
By organisation
School of Medical Sciences
In the same journal
Rheumatology
Rheumatology and Autoimmunity

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 8 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf