Anti-Sm Antibodies May Predict Need for Immunosuppressant Therapy In Lupus Nephritis Patients

Results from a recent study presented at the European League Against Rheumatism Annual European Congress of Rheumatology showed that patients with lupus nephritis (LN) who are positive for anti-Sm antibodies may be more likely to require immunosuppressive therapy.

Lupus nephritis (LN) is kidney inflammation caused by systemic lupus erythematosus (SLE or lupus). SLE is an autoimmune disease—a disorder in which the body’s immune system attacks the body’s own cells and organs. Up to 60 percent of people with SLE are diagnosed with lupus nephritis, which can lead to significant illness and even death.

During the study, the team assessed 90 LN pateints who underwent renal biopsy between 2005 and 2014 at the Yonsei University College of Medicine in Seoul, Korea. Researchers screened patients for anti-Sm antibodies and other serum parameters such as screening for other autoantibodies and complement.

At the time of renal biopsy patients’ median age was 32 years and the study mean follow-up period was of 35.3 months. All patients who had presence of anti-Sm antibodies 6 months before or after or biopsy were excluded from the study.

The results showed that the most frequent LN subtype was class IV, which was observed in 46.6% of patients with LN, followed by class III and class V in 32.2% and 26.6% of patients with LN, respectively. The team found no association between the presence of anti-Sm antibodies and class subtype.

The immunosuppressants considered for treatment of patients with LN were azathioprine, tacrolimus, mycophenolate mofetil, cyclosporine and cyclophosphamide. During follow-up, 81.1% of the LN patients had received treatment with an immunosuppressive at some point.

The results revealed a correlation between the presence of anti-Sm antibodies, age and disease activity and the use of immunosuppressives. Results from the multivariate analysis showed that there was an association between the presence of anti-Sm antibodies and age, disease activity and the use of immunosuppressive agents.