ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 127

Disease Characteristics and Medication Utilization in Lupus Nephritis Associated with Childhood-Onset Systemic Lupus Erythematosus

Emily Smitherman1, Rouba Chahine 1, Timothy Beukelman 1, Laura Lewandowski 2, AKM Fazlur Rahman 1, Scott Wenderfer 3, Aimee Hersh 4 and Jeffrey R Curtis 5 for the CARRA investigators, 1University of Alabama at Birmingham, Birmingham, 2NIAMS, NIH, Rockville, 3Section of Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, 4University of Utah Primary Children's Hospital, Salt Lake City, 5University of Alabama at Birmingham, Hoover

Meeting: 2020 Pediatric Rheumatology Symposium

Keywords: Lupus nephritis, medication, Systemic lupus erythematosus (SLE)

  • Tweet
  • Email
  • Print
Session Information

The 2020 Pediatric Rheumatology Symposium, originally scheduled for April 29 – May 2, was postponed due to COVID-19; therefore, abstracts were not presented as scheduled.

Date: Saturday, May 2, 2020

Title: Poster Session 3

Session Type: ACR Abstract Session

Session Time: 4:15PM-5:15PM

Background/Purpose: Lupus nephritis associated with childhood-onset systemic lupus erythematosus (cSLE) is a significant risk factor for long-term morbidity and mortality, but little is known regarding current cSLE patients with nephritis in North America. Our objective was to characterize demographics, disease characteristics, and medication utilization patterns from a large multi-center cohort of cSLE patients with nephritis.

Methods: We analyzed data previously collected from March 2017 to June 2019 through the longitudinal, observational cSLE cohort in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. Patients with a cSLE-related condition are eligible for registry enrollment if under 18 at the time of symptom onset, within 24 months of new cSLE diagnosis or new diagnosis of nephritis, and under 21 at the time of enrollment. Data collection occurs every 6 months. Diagnosis of lupus nephritis was defined if at least one renal biopsy was recorded with histopathologic classification by either 1995 World Health Organization (WHO) or 2003 International Society of Nephrology (ISN)/Renal Pathology Society (RPS) criteria. We abstracted the following variables: sex, patient-reported race/ethnicity, insurance status, household income, parent education level, age at diagnosis, reported date of symptom onset, date of diagnosis, date of registry enrollment, Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) at enrollment, physician global assessment (PGA) of disease activity (0-10) at enrollment, date of initial renal biopsy, WHO or ISN/RPS classification of initial renal biopsy, and medications prescribed both prior to and following enrollment. Descriptive statistics were calculated using SAS v9.4.

Results: We identified 181 cSLE patients with renal biopsy-proven lupus nephritis from 42 pediatric rheumatology centers. The cohort was 85% female, 33% Black, 24% Hispanic, and 23% White with a mean (SD) age at cSLE diagnosis of 13.4 (2.9) years (Table 1). There was a mean (SD) of 11.6 (17.4) months from time of initial positive renal biopsy to registry enrollment. At enrollment, the median (IQR) SLEDAI-2K was 4 (2-10) and PGA was 2.5 (1-4). On initial biopsy, 16% of patients had class I/II, 61% had class III/IV, 13% had class V, 9% had combined class III/V or IV/V, and 1 patient had class VI. There was high use of hydroxychloroquine and mycophenolate across the cohort, while cyclophosphamide and azathioprine use varied by biopsy classification (Table 2). Across 12 centers with at least 5 patients with nephritis enrolled, wide variation in use of mycophenolate (58-100%), cyclophosphamide (0-86%), and rituximab (0-100%) was observed (Figure 1).

Conclusion: Use of the CARRA Registry provides a large multi-center sample of cSLE patients with lupus nephritis from which to evaluate disease characteristics and medication utilization patterns. This initial analysis demonstrates a diverse cohort of patients with differential medication use patterns across nephritis classification groups and care centers. Continued study of optimal care for cSLE with nephritis is needed to reduce disparities and improve long-term outcomes.


Disclosure: E. Smitherman, None; R. Chahine, None; T. Beukelman, UCB, 1, Novartis, 1; L. Lewandowski, None; A. Rahman, None; S. Wenderfer, None; A. Hersh, None; J. Curtis, AbbVie, 1, Amgen, 1, Bristol-Myers Squibb, 1, Corrona, 1, Lilly, 1, Janssen, 1, Myriad, 1, Pfizer, 1, Regeneron, 1, Roche, 1, UCB, 1.

To cite this abstract in AMA style:

Smitherman E, Chahine R, Beukelman T, Lewandowski L, Rahman A, Wenderfer S, Hersh A, Curtis J. Disease Characteristics and Medication Utilization in Lupus Nephritis Associated with Childhood-Onset Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 4). https://acrabstracts.org/abstract/disease-characteristics-and-medication-utilization-in-lupus-nephritis-associated-with-childhood-onset-systemic-lupus-erythematosus/. Accessed .
  • Tweet
  • Email
  • Print

« Back to 2020 Pediatric Rheumatology Symposium

ACR Meeting Abstracts - https://acrabstracts.org/abstract/disease-characteristics-and-medication-utilization-in-lupus-nephritis-associated-with-childhood-onset-systemic-lupus-erythematosus/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology