Repository logo
 

Predictors of treatment response in a lupus nephritis population: lessons from the Aspreva Lupus Management Study (ALMS) trial.

cam.depositDate2022-02-15
cam.orpheus.counter6
cam.orpheus.successWed Jun 08 08:57:01 BST 2022 - Embargo updated*
dc.contributor.authorMcDonald, Stephen
dc.contributor.authorYiu, Sean
dc.contributor.authorSu, Li
dc.contributor.authorGordon, Caroline
dc.contributor.authorTruman, Matt
dc.contributor.authorLisk, Laura
dc.contributor.authorSolomons, Neil
dc.contributor.authorBruce, Ian N
dc.contributor.authorMASTERPLANS Consortium
dc.contributor.orcidMcDonald, Stephen [0000-0001-7151-7654]
dc.contributor.orcidSu, Li [0000-0003-0919-3462]
dc.contributor.orcidBruce, Ian N [0000-0003-3047-500X]
dc.date.accessioned2022-02-16T00:30:26Z
dc.date.available2022-02-16T00:30:26Z
dc.date.issued2022-05
dc.date.updated2022-02-15T10:07:48Z
dc.description.abstractOBJECTIVES: 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 <1 year) and 24-hour urine protein (0.63 (0.45 to 0.89)) were negative predictors of CRR. LN duration 2-4 years (0.45 (0.24 to 0.83) vs <1 year) negatively predicted PRR. The AUROCs of models for improvement, CRR and PRR were 0.56, 0.55 and 0.51 respectively. CONCLUSIONS: Baseline variables predicted 6-month outcomes in patients with SLE. While the modest performance of models emphasises the need for new biomarkers to advance this field, the factors identified can help identify those patients who may require novel treatment strategies.
dc.identifier.doi10.17863/CAM.81473
dc.identifier.eissn2053-8790
dc.identifier.issn2053-8790
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/334062
dc.language.isoeng
dc.publisherBMJ Publishing Group
dc.publisher.departmentMrc Biostatistics Unit
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.titlePredictors of treatment response in a lupus nephritis population: lessons from the Aspreva Lupus Management Study (ALMS) trial.
dc.typeArticle
dcterms.dateAccepted2022-02-09
prism.publicationNameLupus Sci Med
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
pubs.licence-identifierapollo-deposit-licence-2-1
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1136/lupus-2021-000584

Files

Original bundle
Now showing 1 - 5 of 5
No Thumbnail Available
Name:
Main Document.docx
Size:
85.61 KB
Format:
Unknown data format
Description:
Accepted version
Licence
https://creativecommons.org/licenses/by/4.0/
Loading...
Thumbnail Image
Name:
Figure 1.pdf
Size:
419.02 KB
Format:
Adobe Portable Document Format
Description:
Supporting information
Licence
https://creativecommons.org/licenses/by/4.0/
Loading...
Thumbnail Image
Name:
Supplementary Figure 1 (FEB 22).pdf
Size:
28.95 KB
Format:
Adobe Portable Document Format
Description:
Supporting information
Licence
https://creativecommons.org/licenses/by/4.0/
Loading...
Thumbnail Image
Name:
Supplementary Figure 2 (FEB 22).pdf
Size:
30.04 KB
Format:
Adobe Portable Document Format
Description:
Supporting information
Licence
https://creativecommons.org/licenses/by/4.0/
Loading...
Thumbnail Image
Name:
Supplementary Figure 3 (FEB 22).pdf
Size:
30.19 KB
Format:
Adobe Portable Document Format
Description:
Supporting information
Licence
https://creativecommons.org/licenses/by/4.0/