Publication:
Urine TWEAK level as a biomarker for early response to treatment in active lupus nephritis: A prospective multicentre study

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Issued Date

2019

Resource Type

Article

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application/pdf

ISSN

20538790

DOI

10.1136/lupus-2018-000298

Other identifier(s)

2-s2.0-85065745297

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Scopus

Bibliographic Citation

Lupus Science and Medicine. Vol 6, No.1 (2019)

Suggested Citation

Suttichet T.B., Kittanamongkolchai W., Phromjeen C., Anutrakulchai S., Panaput T., Ingsathit A., Kamanamool N., Ophascharoensuk V., Sumethakul V., Avihingsanon Y. Urine TWEAK level as a biomarker for early response to treatment in active lupus nephritis: A prospective multicentre study. Lupus Science and Medicine. Vol 6, No.1 (2019). doi:10.1136/lupus-2018-000298 Retrieved from: https://hdl.handle.net/20.500.14740/5399

Title

Urine TWEAK level as a biomarker for early response to treatment in active lupus nephritis: A prospective multicentre study

Author(s)

Suttichet T.B.
 Kittanamongkolchai W.
 Phromjeen C.
 Anutrakulchai S.
 Panaput T.
 Ingsathit A.
 Kamanamool N.
 Ophascharoensuk V.
 Sumethakul V.
 Avihingsanon Y.

Abstract

Background TNF-like weak inducer of apoptosis (TWEAK) is a proinflammatory molecule that plays a key role in active inflammation of lupus nephritis (LN). Urine TWEAK (uTWEAK) levels were found to be associated with renal disease activity among patients with LN. Here, we determined whether serial measurements of uTWEAK during induction therapy could predict treatment response or not. Methods Spot urine samples were collected from patients with biopsy-proven active LN at time of flare, and 3 and 6 months after flare to assess the uTWEAK levels. All patients received standard immunosuppressive therapy and treatment response was evaluated at 6 months. The performance of uTWEAK as a predictor for treatment response was compared with clinically used biomarkers for patients with LN. Results Among 110 patients with LN, there were 29% complete responders (CR), 34% partial responders (PR) and 37% non-responders (NR). On average, uTWEAK level was consistently low in CR, trended down by 3 months in PR and persistently elevated in NR. uTWEAK levels at month 3 were able to predict complete response at month 6 (OR adjusted for age, sex and creatinine=0.34 [95% CI 0.15 to 0.80], the area under the receiver operating characteristic curve [ROC-AUC]=0.68, p=0.02). The optimal threshold for uTWEAK level at month 3 was 0.46 pg/mgCr, discriminating complete response with 70% sensitivity and 63% specificity. Combining uTWEAK and urine protein at month 3 improved predictive performance for complete response at 6 months (ROC-AUC 0.83, p<0.001). Conclusions In addition to urine protein, uTWEAK level at 3 months after flare can improve the accuracy in predicting complete response at 6 months of induction therapy. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

Subject(s)

Albumin
 Azathioprine
 Creatinine
 Cyclophosphamide
 Mycophenolate mofetil
 Mycophenolic acid
 Prednisone
 Tacrolimus
 Tumor necrosis factor ligand superfamily member 12
 Adult
 Albumin blood level
 Article
 Chronicity
 Controlled study
 Creatinine blood level
 Disease severity
 Female
 Glomerulus filtration rate
 Human
 Immunosuppressive treatment
 Kidney biopsy
 Lupus erythematosus nephritis
 Maintenance therapy
 Major clinical study
 Male
 Multicenter study
 Priority journal
 Prospective study
 Protein urine level
 Randomized controlled trial
 Randomized controlled trial (topic)
 SLEDAI
 Treatment response
 Treatment response time
 Urine sampling

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https://hdl.handle.net/20.500.14740/5399

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Scopus: Year 1983-2021

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