Treatment patterns and outcomes of first lupus nephritis episode over 25 years in two Latin American cohorts
No hay miniatura disponible
Archivos
Fecha
2026
Autores
Quintana, Rosana
Hernandez, Lucia
Pons-Estel, Guillermo
Scolnik, Marina
Subils, Gisela
Otaduy, Cintia
Saurit, Verónica
Arturi, Valeria
Berbotto, Guillermo A.
Gonzalez Lucero, Luciana
Título de la revista
ISSN de la revista
Título del volumen
Editor
SAGE
Resumen
Abstract
Objectives: To compare the treatments used for the first episode of lupus nephritis (LN) in two Latin American cohorts (historical and contemporary) over a 25-year period, and their associations with clinical outcomes.
Methods: Patients with biopsy-confirmed first LN episode were classified as non-proliferative (class V) or proliferative (classes III/IV). Sociodemographic, clinical, and treatment variables were described. Propensity score matching was used to examine the associations with four outcomes: mortality, damage accrual (SDI), hospitalization, and end-stage renal disease (ESRD).
Results: A total of 532 SLE patients were included: 362 from GLADEL 1.0 (historical cohort) and 170 from GLADEL 2.0. (contemporary). Compared to GLADEL 1.0, patients in GLADEL 2.0 received lower doses of oral glucocorticoids (GC), more frequently GC pulses and antimalarials but less frequently cyclophosphamide. An increase in the use of mycophenolate mofetil and other immunosuppressants was also observed. In the logistic regression models, SDI was associated with baseline SDI and GC pulses, whereas belonging to the GLADEL 2.0 was a protective factor. Mortality was associated with Mestizo ethnicity and partial health coverage; antimalarial was identified as a protective factor. Hospitalizations were associated with baseline SLEDAI and SDI, follow-up time, and lower educational level. Belonging to the GLADEL 2.0 cohort was protective against the occurrence of ESRD. Conclusions: Patients in the contemporary cohort benefited from advances in treatment strategies, with less cumulative damage and progression to ESRD, although mortality remained unchanged. These improvements likely reflect the increased use of newer therapies, more targeted approaches, in line with current treatment guidelines, and better access to specialized care.
Descripción
Palabras clave
Lupus erythematosus systemic, Lupus nephritis, Treatment, Epidemiology, Latin American
Citación
Quintana R, Hernández L, Pons-Estel G, Scolnik M, Subils G, Cintia O, Saurit V, Arturi V, Berbotto GA, Lucero LG, Kerzberg EM, Perez N, Pisoni CN, Crespo ME, Serventi JM, Montandon ACOS, Monticielo OA, Mariz HA, Klumb EM, Borba EF, Costa Seguro LP, Torres Dos Reis-Neto E, Bonfa E, Peralta AB, Mimica M, Martínez GA, Bonfanti AC, Cañas CA, Quintana-Lopez G, Toro Gutiérrez CE, Moreno Alvarez MJ, Saavedra MÁ, Hernández MP, Fragoso-Loyo H, Silveira LH, García-Valladares I, Abud-Mendoza C, Esquivel Valerio JA, Langjahr P, Paats A, Mora-Trujillo CS, Ugarte-Gil MF, Quiroz AC, Louis RM, Rebella M, Danza Á, Orillion A, Karyekar C, Zazzetti F, Alarcón GS, Pons-Estel BA. Treatment patterns and outcomes of first lupus nephritis episode over 25 years in two Latin American cohorts. Lupus. 2026 Apr 28:9612033261445765. doi: 10.1177/09612033261445765. Epub ahead of print. PMID: 42047097.