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Kidney Week

Abstract: FR-PO0825

Anifrolumab Use in Patients with Lupus Nephritis Is Associated with Decreased Progression to ESRD

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Khandwala, Lay Mehul, All India Institute of Medical Sciences Jodhpur, Jodhpur, RJ, India
  • Khandwala, Pushti Varshangbhai, Concord Hospital Laconia, Laconia, New Hampshire, United States
Background

Lupus nephritis (LN) is an autoimmune disorder involving immune complex deposition in the glomerulus and is known to lead to End-stage Renal disease (ESRD) in 22%of patients.[1] Anifrolumab, an interferon alpha receptor antagonist, has been shown to have great safety and efficacy in treatment of patients with active lupus nephritis. In this study, we look into the effectiveness of Anifrolumab to slow down the progression of LN patients to ESRD.

Methods

TrinetX, a global federated research network that provides a dataset of electronic medical records from different healthcare organizations was utilized to query patients with LN. Further, two subgroups were made based on the use of Anifrolumab. Propensity score matching (PSM) was carried out to match age, sex, race, ethnicity, hypertension, and diabetes mellitus. Compare outcome analytic function was utilized to determine patients who developed ESRD.

Results

37,289 cases were identified with LN, of whom 242 (0.65%) received Anifrolumab. Patients who received Anifrolumab were young (40.4 ± 13.3 vs 43 ± 17.1 years, p=0.0172), and majority were females (0.71% vs 0.30%, p=0.000281) and African Americans (0.80%, compared to 0.59% whites, p=0.003753).
Before matching, 7.85% (n=19) of patients receiving Anifrolumab developed ESRD compared to 24.96% (n=9,232) patients who did not get Anifrolumab (p<0.0001, OR = 0.256, 0.16-0.409). Patients receiving Anifrolumab had ~62% lower risk of developing ESRD compared to patients not receiving it (HR = 0.38, 0.244 - 0.601).
After matching, both cohorts had 241 cases each. The development of ESRD in patients receiving Anifrolumab was significantly low, compared to patients not receiving it (7.88% vs 18.26%, OR 0.383 (0.216-0.678), p=0.0007). Patients receiving Anifrolumab had ~64% lower risk of developing ESRD compared to patients not receiving it (HR = 0.36, 0.21 - 0.618).

Conclusion

In this real-world data study, we illicit that the use of Anifrolumab in LN patients has decreased association with ESRD. Further prospective studies are required to ascertain the use of Anifrolumab in the prevention of ESRD in LN patients.

Digital Object Identifier (DOI)