Intensified B-cell depletion induction therapy without maintenance effective in lupus nephritis
Intensified B-cell depletion induction therapy (IBCDT) without immunosuppressive maintenance therapy was found to be as effective as standard of care in patients with biopsy-proven lupus nephritis (LN), according to a study.
IBCDT followed by oral prednisone and no immunosuppressive maintenance therapy was the treatment regimen followed by 30 patients. A total of 30 patients were matched for LN class and age and treated with either methylprednisolone pulses followed by oral prednisone and mycophenolate mofetil (MMF) or Euro Lupus cyclophosphamide (CYC) and >3 years of maintenance therapy.
At 12 months, 93% of patients on IBCDT had achieved complete renal remission compared to 62.7% on MMF, and 75% on CYC. Patients on IBCDT had the lowest dose of oral prednisone.
There were no significant differences in proteinuria and serum creatinine levels or frequency of new flares between the 3 groups at the final follow-up visit (mean 44.5 months for IBCDT, 48.6 months for MMF, and 45.3 months for CYC).
Roccatello D, Sciascia S, Naretto C, et al. A prospective study on long-term clinical outcomes of patients With lupus nephritis treated with an intensified B-cell depletion protocol without maintenance therapy. Kidney Int Rep. 2021;6(4):1081-1087. DOI: 10.1016/j.ekir.2021.01.027. PMID: 33912758; PMCID: PMC8071649.