ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1793

Safety of Obtaining Research Tissue During Clinically Indicated Kidney Biopsies: Data from the Lupus Accelerating Medicines Partnership

Kristina Deonaraine1, Philip Carlucci1, Andrea Fava2, Jessica Li3, David Wofsy4, Judith James5, Chaim Putterman6, Betty Diamond7, Derek Fine8, Jose Monroy-Trujillo8, Kristin Haag8, William Apruzzese9, H. Michael Belmont10, Peter Izmirly11, Sean Connery12, Fernanda Payan-Schober12, Richard Furie13, Celine Berthier14, Maria Dall'Era15, Kerry Cho16, Diane Kamen17, Kenneth Kalunian18, The Accelerating Medicines Partnership in SLE Network19, Michelle Petri20 and Jill Buyon21, 1New York University School of Medicine, New York, 2Johns Hopkins, Baltimore, 3Johns Hopkins University, Baltimore, MD, 4University of California San Francisco, San Francisco, CA, 5Oklahoma Medical Research Foundation, Oklahoma City, 6Albert Einstein College of Medicine, Bronx, NY, 7Northwell Health, Hartford, 8Johns Hopkins University, Baltimore, 9., Boston, 10NYU School of Medicine, New York, NY, 11Department of Medicine, New York University School of Medicine, New York, NY, 12Texas Tech University Health Sciences Center, Lubbock, 13Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, 14University of Michigan, Ann Arbor, 15Division of Rheumatology, University of California, San Francisco, CA, 16University of California San Francisco, San Francisco, 17Medical University of South Carolina, Charleston, SC, 18School of Health Sciences, University of California, La Jolla, 19Multiple Institutions, Multiple Cities, 20Johns Hopkins University School of Medicine, Baltimore, 21New York University, New York, NY

Meeting: ACR Convergence 2020

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

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Monday, November 9, 2020

Session Title: SLE – Diagnosis, Manifestations, & Outcomes Poster III: Bench to Bedside

Session Type: Poster Session D

Session Time: 9:00AM-11:00AM

Background/Purpose:

Lupus nephritis (LN) is a major complication of systemic lupus erythematous (SLE) and affects ~60% of patients during the course of their disease, leading to significant morbidity and mortality. Previous studies examining the safety of percutaneous kidney biopsy to diagnose LN have found variable complication rates depending on disease type studied, ranging from 4-11% in autoimmune/SLE patients to 15-17% in safety studies of any kidney disease. The purpose of our study was to define the safety of obtaining additional tissue for research during clinically indicated renal biopsies in a SLE cohort.

Methods:

Patients were enrolled across 15 clinical US sites in the SLE Accelerating Medicines Partnership (AMP). Kidney biopsies were clinically indicated to evaluate proteinuria (urine protein creatinine ratio [uPCR] > 0.5). Patients with a history of renal transplant, use of rituximab within 6 months of biopsy, and current pregnancy were excluded. Ultrasound/CT-guided kidney biopsies were performed by interventional radiologists/nephrologists generally using an 18-gauge needle although technique, number of routine passes and core lengths varied. An additional core taken solely for research purposes, or a piece of core with sufficient glomeruli remaining from the routine passes and not required for clinical diagnosis, was collected.  All adverse events (AEs) occurring within 30 days of biopsy were reported, including duration, severity, type, and resolution.

Results: 482 patients underwent a renal biopsy between 2014 and 2020. All patients met criteria for SLE (ACR or SLICC) and the majority were female (85%). Pathologic assessment of clinical biopsies revealed ISN/RPS Class I-VI for most biopsies, although 45 biopsies (9%) yielded a non-LN diagnosis (Table 1). Overall, 37 patients (8%) experienced an AE with several more than one, with a total of 41 AEs reported.  Of these AEs, 8 (20%) were considered by the site investigator to be unrelated or unlikely to be related (included pain, shortness of breath, cardiac arrest, fall, and hemoglobin decrease due to sepsis) and 33 (80%) were deemed possibly, probably, or definitely  related to the study procedure. Of these events, 9/33 (28%) were mild, 10 (30%) were moderate, and 12 (36%) were deemed severe. In 18 patients (4%) the AEs were considered serious as defined by inpatient or prolonged hospitalization, significant incapacity, or requiring intervention to prevent permanent impairment. The most common related AEs were bleed-related complications, including hematoma, hemorrhage, and hemoglobin decrease (N= 29).  Of these, 18 required hospitalization, with 4 of these patients receiving a blood transfusion.  All 29 bleed-related complications resolved. The length of the research biopsy did not associate with an AE. 

Conclusion: Procurement of an additional kidney biopsy core for research purposes in SLE patients undergoing a clinically-indicated kidney biopsy did not result in an increase in adverse events compared to the adverse event rate in prior studies of the safety of percutaneous kidney biopsy.  Accordingly, inclusion of a research core should be considered feasible for future studies to advance discovery of new therapeutic targets and prognostic indicators in LN.

Table 1. Patient characteristics at time of kidney biopsy.


Disclosure: K. Deonaraine, None; P. Carlucci, None; A. Fava, None; J. Li, None; D. Wofsy, GlaxoSmithKline, 9, Novartis, 9, Principia, 5; J. James, None; C. Putterman, Equillium, 1, 2; B. Diamond, None; D. Fine, GSK, 5; J. Monroy-Trujillo, None; K. Haag, None; W. Apruzzese, None; H. Belmont, Exagen, 5; P. Izmirly, GSK, 5; S. Connery, None; F. Payan-Schober, None; R. Furie, AstraZeneca/MedImmune, 2, 5; C. Berthier, None; M. Dall'Era, Janssen, 5, AstraZeneca, 5; K. Cho, None; D. Kamen, None; K. Kalunian, AstraZeneca, 2, 5, AbbVie, 2, 5, Amgen, 2, 5, Biogen, 2, 5, Bristol-Myers Squibb, 2, 5, Eli Lilly, 2, 5, Equillium, 2, 5, Gilead Sciences, Inc., 2, 5, Genentech, 2, 5, ILTOO, 2, 5, Janssen, 2, 5, Lupus Research Alliance, 2, 5, Nektar, 2, 5, Pfizer, 2, 5, Roche, 2, 5, Sanford Consortium, 2, 5, Vielabio, 2, 5; T. Accelerating Medicines Partnership in SLE Network, None; M. Petri, AbbVie, 5, Amgen, 5, AstraZeneca, 2, 5, BMS, 5, Decision Resources, 5, GSK, 2, 5, INOVA, 5, IQVIA, 5, Janssen, 5, Eli Lilly, 2, 5, Merck EMD Serono, 5, Sanofi Japan, 5, Thermofisher, 5, UCB, 5, Exagen, 2; J. Buyon, Exagen Diagnostics, 1.

To cite this abstract in AMA style:

Deonaraine K, Carlucci P, Fava A, Li J, Wofsy D, James J, Putterman C, Diamond B, Fine D, Monroy-Trujillo J, Haag K, Apruzzese W, Belmont H, Izmirly P, Connery S, Payan-Schober F, Furie R, Berthier C, Dall'Era M, Cho K, Kamen D, Kalunian K, Accelerating Medicines Partnership in SLE Network T, Petri M, Buyon J. Safety of Obtaining Research Tissue During Clinically Indicated Kidney Biopsies: Data from the Lupus Accelerating Medicines Partnership [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/safety-of-obtaining-research-tissue-during-clinically-indicated-kidney-biopsies-data-from-the-lupus-accelerating-medicines-partnership/. Accessed March 3, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/safety-of-obtaining-research-tissue-during-clinically-indicated-kidney-biopsies-data-from-the-lupus-accelerating-medicines-partnership/

Advanced Search

Your Favorites

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

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.