학술논문
Predictors of treatment response in a lupus nephritis population: lessons from the Aspreva Lupus Management Study (ALMS) trial
Document Type
article
Author
Neil Solomons; Ian N Bruce; Paul Emery; Caroline Gordon; Edward Vital; David Jayne; David Isenberg; Neil McHugh; Miriam Wittmann; Stephen Young; John Reynolds; Niels Peek; Mark Lunt; Li Su; Sean Gavan; Katherine Payne; Michael Ehrenstein; Vern Farewell; Timothy Vyse; Marina Botto; David Lester Morris; D D’Cruz; Nophar Geifman; Angela Midgley; Matt Truman; Stephen McDonald; Sean Yiu; Laura Lisk; Gillian Armitt; Jennifer Prattley; Narges Azadbakht; Angela Papazian; Helen Le Sueur; Carmen Farrelly; Clare Richardson; Zunnaira Shabbir; Lauren Hewitt; Matthew Pickering; Elizabeth Lightstone; Alyssa Gilmore; Michael Beresford; Christian Hedrich; Jenna Gritzfeld; Mariea Parvaz; Jane Dunnage; Jane Batchelor; E Holland; Pauline Upsall
Source
Lupus Science and Medicine, Vol 9, Iss 1 (2022)
Subject
Language
English
ISSN
2053-8790
Abstract
Objectives To identify predictors of overall lupus and lupus nephritis (LN) responses in patients with LN.Methods Data from the Aspreva Lupus Management Study (ALMS) trial cohort was used to identify baseline predictors of response at 6 months. Endpoints were major clinical response (MCR), improvement, complete renal response (CRR) and partial renal response (PRR). Univariate and multivariate logistic regressions with least absolute shrinkage and selection operator (LASSO) and cross-validation in randomly split samples were utilised. Predictors were ranked by the percentage of times selected by LASSO and prediction performance was assessed by the area under the receiver operating characteristics (AUROC) curve.Results We studied 370 patients in the ALMS induction trial. Improvement at 6 months was associated with older age (OR=1.03 (95% CI: 1.01 to 1.05) per year), normal haemoglobin (1.85 (1.16 to 2.95) vs low haemoglobin), active lupus (British Isles Lupus Assessment Group A or B) in haematological and mucocutaneous domains (0.61 (0.39 to 0.97) and 0.50 (0.31 to 0.81)), baseline damage (SDI>1 vs =0) (0.38 (0.16 to 0.91)) and 24-hour urine protein (0.63 (0.50 to 0.80)). LN duration 2–4 years (0.43 (0.19 to 0.97) vs