Tuesday, 18 Feb 2020

You are here

Improved Mortality Trends in Lupus Nephritis

The mortality rate from end- stage renal disease (ESRD) in lupus nephritis (LN) patients has significantly decreased in the last decade.

Noting studies that showed premature mortality among ESRD lupus nephritis patients, researchers set out to examine if these trends have continued. Using national registry data through 2014, they studied 20,974 patients with incident ESRD due to LN between January 1, 1995 and December 31, 2014 and examined outcomes in 5-year blocks (1995–1999, 2000–2004, 2005–2009, 2010–2014).

Between 1995 through 2014, the mortality rate per 100 patient- years declined steadily:

  • 1995–1999 - 11.1 (95% confidence interval [95% CI] 10.4–11.8)
  • 2010–2014 - 6.7 (95% CI 6.2–7.2) (P trend < 0.01).

Compared with 1995–1999, the adjusted mortality hazard ratios in 2010–2014 were lower for whites (0.68;0.58–0.78), African Americans (0.67; 0.57–0.78), and for Hispanics (0.51; 0.38–0.69).

Deaths from cardiovascular disease (CVD) and infection declined by 44% and 63%, over this same period (p< 0.01 for both).

It appears that improving care in this high- risk population has lead to a reduction in all- cause mortality among white, African American, and Hispanic patients, with reduced risk of death from CVD and infection. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

BSR Guidelines for Giant Cell Arteritis

NICE has commissioned an update to the 2010 British Society for Rheumatology guideline for the management of giant cell arteritis, and proposed a total of 19 recommendations for the diagnosis and treatment of GCA.

PEXIVAS - Plasma Exhange Fails to Boost Outcomes in Severe AAV

The PEXIVAS study showed that plasma exchange did not reduce the incidence of death or ESKD in patients with severe ANCA–associated vasculitis.

Shingles Vaccine Lowers Risk of CVA

Shingles infection has been historically linked to an increased risk of stroke. A new study found that Zoster Vaccine Live, one type of shingles vaccination, may prevent stroke in some older adults.

EULAR Recommendations on Sjögren’s Syndrome

The European League Against Rheumatism (EULAR) has established an international collaborative group (EULAR SS Task Force) to develop the first EULAR evidence and consensus-based recommendations for the management of patients with Sjogens syndrome (SjS).

Steroid-Sparing Effect of Tocilizumab in Refractory Takayasu Arteritis

A controlled clinical trial has shown that giving the IL-6 receptor antibody, tocilizumab (TCZ), to  patients with Takayasu arteritis (TAK) results in clinical efficacy and has a steroid sparing efffect.