The Steroids In the Maintenance of remission of Proliferative Lupus nephritis (SIMPL) pilot trial

Canadian Journal of Kidney Health and Disease
Lauren GalbraithMichael Walsh

Abstract

Patients with proliferative lupus nephritis are at risk of frequent relapses. Whether low- dose prednisone prevents relapses is uncertain. We undertook a pilot RCT to determine the feasibility of a larger trial. Pilot randomized controlled trial. Single center Canadian outpatient nephrology clinic. Participants with systemic lupus erythematosus (SLE) and a history of class III or IV lupus nephritis that achieved at least partial remission and remained on prednisone were eligible. Feasibility: proportion of eligible patients randomized and adherence to tapering regimen. Clinical: occurrence of renal or major non-renal flare of SLE. We conducted a blinded, two-parallel-group randomized controlled trial of prednisone 7.5 mg/day (continuation) compared to a matching placebo (withdrawal). Of nineteen eligible patients screened, 15 (79%) were recruited and randomized; 8 to prednisone continuation and seven to withdrawal. All participants adhered to the tapering protocol to their assigned withdrawal or low-dose maintenance target. Over 36 months, the primary outcome occurred in four (50%) patients in the continuation group (three renal and one major non-renal flare), compared with one patient (14%) in the withdrawal group (one renal f...Continue Reading

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Citations

Dec 26, 2016·Rheumatology·Diane Apostolopoulos, Eric F Morand
Dec 14, 2018·Clinical Rheumatology·Rudra Prosad GoswamiAlakendu Ghosh
Jun 30, 2018·The Cochrane Database of Systematic Reviews·David J TunnicliffeGiovanni Fm Strippoli
Nov 9, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Salem AlmaaniBrad H Rovin
Mar 16, 2021·Zeitschrift für Rheumatologie·Rebecca Fischer-Betz, Matthias Schneider
Jun 25, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Gabriella MoroniClaudio Ponticelli

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