AB0530 Treatment outcome in lupus nephritis patients treated with mycophenolate mofetil: from real-world clinical practice

Background Systemic lupus erythematosus (SLE) is a systemic autoimmune disease often characterised by the development of glomerulonephritis.1 There is a growing interest in the use of mycophenolate mofetil (MMF) as induction therapy and maintenance therapy for lupus nephritis.2, 3 Objectives This study aimed to evaluate the therapeutic outcome of MMF in lupus nephritis from real-world clinical practice, and identify the predictors for failure of remission after MMF treatment. Methods Korean patients with pathologically proven lupus nephritis class III, IV, and V were recruited from rheumatology clinic in Severance Hospital, Yonsei University College of Medicine between Nov 2011 and Aug 2017 Patients who treated with MMF for at least 3 months were included in the analysis. The probability of remission after MMF therapy, and the difference between patients who achieved remission or failed to achieve remission were analysed using Kaplan-Meier analysis and Cox proportional hazards model. Results Of 153 patients with lupus nephritis, 116 patients were included in this study. Seventy two patients continued MMF until the last follow-up. The mean age of patients was 34.2 years, and the median duration of SLE was 5.7 months. Anti-dsDNA antibody was positive in 82.8% of patients, and 9.5% of patients showed a histological class with pure V pathology. Mean protein/creatinine ratio in spot urine was 4.6, and active urinary sediment was found in 82.8% of patients. During median follow-up period of 5 years, 80% of patients achieved clinical remission of lupus nephritis. Median time to remission was 4.2 months (IQR 0.9–9.1). Risk factors for failure of remission were nephrotic-range proteinuria and seronegativity of anti-dsDNA antibodies. Conclusions This study shows the real-world data on MMF treatment in patients with lupus nephritis. Patients with risk factors for failure to remission may require more intensive treatment and management. References [1] Yu F, Haas M, Glassock R, Zhao MH. Redefining lupus nephritis: clinical implications of pathophysiologic subtypes, Nature reviews. Nephrology13 (2017) 483–495. [2] Ginzler EM, Dooley MA, Aranow C, Kim MY, Buyon J, Merrill JT, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. The New England journal of medicine2005;353(2005):2219–2228. [3] Dooley MA, Jayne D, Ginzler EM, Isenberg D, Olsen NJ, Wofsy D, et al. Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis. The New England journal of medicine2011;365(2011):1886–1895. Acknowledgements None Disclosure of Interest None declared