Risk stratification for infection during immunosuppressive therapy in patients with lupus nephritis : A nested case-control study

BACKGROUND: The current prediction models for the risk of infection during immunosuppressive treatment for lupus nephritis (LN) lack a prediction time window and have poor pertinence. This study aimed to develop a risk stratification to predict infection during immunosuppressive therapy in patients with LN.

METHODS: This retrospective nested case-control study collected patients with LN treated with immunosuppressive therapy between 2014 and 2022 in the Nephrology ward in Huashan Hospital affiliated to Fudan University and Huashan Hospital Baoshan Branch. Cases were defined as patients who experienced infection during the follow-up period; patients were eligible as controls if they did not have infection during the follow-up period.

RESULTS: There were 53 patients with infection by CTCAE V5.0 grade ≥2. According to the 1:3 nested matching, the 53 patients with infection were matched with 159 controls. In the multivariable logistic regression model, the change rate of fibrinogen (OR = 0.97, 95% CI: 0.94-0.99, p = 0.008), leukopenia (OR = 8.68, 95% CI: 1.16-301.72, p = 0.039), and reduced albumin (OR = 6.25, 95% CI: 1.38-28.24, p = 0.017) were independently associated with infection. The AUC of the ROC curve in the validation set of the multivariable logistic regression model in the internal random sampling was 0.864. The scores range from -2 to 10. The infection risk stratification ranges from 2.8% at score -2 to 97.5% at score 10.

CONCLUSION: A risk stratification was built to predict the risk of infection in patients with LN undergoing immunosuppressive therapy.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Lupus - (2024) vom: 25. Apr., Seite 9612033241248722

Sprache:

Englisch

Beteiligte Personen:

Lu, Jianda [VerfasserIn]
Wu, Yuanhao [VerfasserIn]
Xue, Jun [VerfasserIn]
Hao, Chuanming [VerfasserIn]

Links:

Volltext

Themen:

Immunosuppressive therapy
Infection
Journal Article
Lupus nephritis
Nested case-control studies
Predictive model

Anmerkungen:

Date Revised 25.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1177/09612033241248722

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM371513901