by Elana Gotkine
edited by Stephanie Baum, reviewed by Robert Egan
In lupus nephritis, attainment of complete renal response (CRR)/partial renal response (PRR) and lupus low disease activity state (LLDAS) is associated with best relapse-free survival, with independent associations seen with lupus nephritis relapse risk reduction, according to a study published online July 20 in Arthritis Care & Research.
Chak Kwan Cheung, M.B.B.S., from The University of Hong Kong, and colleagues examined the frequency and predictors of LLDAS attainment and its impact on relapse and renal function preservation in patients with lupus nephritis. A total of 245 adult patients with lupus nephritis were included: 143 in the discovery cohort and 102 in the validation cohort.
The researchers found that 40%, 10%, 49%, and 10% of patients in the discovery cohort achieved CRR, PRR, LLDAS, and DORIS (Definition Of Remission In Systemic Lupus Erythematosus) remission, respectively, at 12 months. Associations were seen for attainment of both CRR/PRR and LLDAS at 12 months with best relapse-free survival.
Independent associations were seen for CRR/PRR and LLDAS with lupus nephritis relapse risk reduction (hazard ratios, 0.31 and 0.38, respectively). Attainment of LLDAS predicts renal function preservation; in both discovery and validation cohorts, performance was satisfactory (area under the receiver operating characteristic curve, 0.71).
“This study provides evidence of LLDAS as an attainable treatment target in lupus nephritis,” the authors write. “The attainment of LLDAS alone or complementary to CRR/PRR was associated with a reduced risk of lupus nephritis relapse.”
More information: Chak Kwan Cheung et al, Treating lupus nephritis patients to lupus low disease activity reduces renal relapse and preserves long‐term kidney function, Arthritis Care & Research (2025). DOI: 10.1002/acr.25611
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