{"id":65322,"date":"2023-03-09T12:38:17","date_gmt":"2023-03-09T11:38:17","guid":{"rendered":"https:\/\/cri1149.fr\/?post_type=publications&#038;p=65322"},"modified":"2025-09-11T16:47:57","modified_gmt":"2025-09-11T14:47:57","slug":"weaning-of-maintenance-immunosuppressive-therapy-in-lupus-nephritis-win-lupus-results-of-a-multicentre-randomised-controlled-trial","status":"publish","type":"publication","link":"https:\/\/cri1149.fr\/en\/publication\/weaning-of-maintenance-immunosuppressive-therapy-in-lupus-nephritis-win-lupus-results-of-a-multicentre-randomised-controlled-trial\/","title":{"rendered":"Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial"},"content":{"rendered":"","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"_EventAllDay":false,"_EventTimezone":"","_EventStartDate":"","_EventEndDate":"","_EventStartDateUTC":"","_EventEndDateUTC":"","_EventShowMap":false,"_EventShowMapLink":false,"_EventURL":"","_EventCost":"","_EventCostDescription":"","_EventCurrencySymbol":"","_EventCurrencyCode":"","_EventCurrencyPosition":"","_EventDateTimeSeparator":"","_EventTimeRangeSeparator":"","_EventOrganizerID":[],"_EventVenueID":[],"_OrganizerEmail":"","_OrganizerPhone":"","_OrganizerWebsite":"","_VenueAddress":"","_VenueCity":"","_VenueCountry":"","_VenueProvince":"","_VenueState":"","_VenueZip":"","_VenuePhone":"","_VenueURL":"","_VenueStateProvince":"","_VenueLat":"","_VenueLng":"","_VenueShowMap":false,"_VenueShowMapLink":false},"category_publication":[],"class_list":["post-65322","publication","type-publication","status-publish","hentry"],"acf":{"numero_de_publication":"Ann Rheum Dis.","date_de_publication":"20221001","numero_doi":"","equipe":[101],"auteurs-liste":[{"texte_libre":true,"auteur-lien":null,"auteur-text":"Noemie Jourde-Chiche"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Nathalie Costedoat-Chalumeau"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Karine Baumstarck"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Anderson Loundou"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Laurence Bouillet"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"St\u00e9phane Burtey"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Val\u00e9rie Caudwell"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Laurent Chiche"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Lionel Couzi"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Laurent Daniel"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Christophe Deligny"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Bertrand Dussol"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Stanislas Faguer"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Pierre Gobert"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Guillaume Gondran"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Antoine Huart"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Aur\u00e9lie Hummel"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Emilie Kalbacher"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Adexandre Karra"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Marc Lambert"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"V\u00e9ronique Le Guern"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Ludivine Lebourg"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Sandrine Loubi\u00e8re"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"H\u00e9l\u00e8ne Maillard-Lefebvre"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Fran\u00e7ois Maurier"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Micheline Pha"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Viviane Queyrel"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Philippe Remy"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Fran\u00e7oise Sarrot-Reynauld"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"David Verhelst"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Eric Hachulla"},{"texte_libre":true,"auteur-lien":null,"auteur-text":"Zahir Amoura"},{"texte_libre":false,"auteur-lien":13058,"auteur-text":""},{"texte_libre":true,"auteur-lien":null,"auteur-text":"WIN-Lupus study group"}],"auteurs-manuel":"","liens_externes":null,"liens":[{"lien":"https:\/\/pubmed.ncbi.nlm.nih.gov\/35725295\/"}],"paragraphe":"[:fr]<h2 class=\"title\" style=\"text-align: justify;\">Abstract<\/h2>\r\n<div id=\"eng-abstract\" class=\"abstract-content selected\">\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Objectives:\u00a0<\/strong>Lupus nephritis (LN) is a frequent complication of systemic lupus erythematosus (SLE). Severe (proliferative) forms of LN are treated with induction immunosuppressive therapy (IST), followed by maintenance IST, to target remission and avoid relapses. The optimal duration of maintenance IST is unknown. The WIN-Lupus trial tested whether IST discontinuation after 2\u20123 years was non-inferior to IST continuation for two more years in proliferative LN.<\/p>\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Methods:\u00a0<\/strong>WIN-Lupus was an investigator-initiated multicentre randomised controlled trial. Patients receiving maintenance IST with azathioprine or mycophenolate mofetil for 2-3 years, and hydroxychloroquine, were randomised (1:1) into two groups: (1) IST continuation and (2) IST discontinuation. The primary endpoint was the relapse rate of proliferative LN at 24 months. Main secondary endpoints were the rate of severe SLE flares, survival without renal relapse or severe flare, adverse events.<\/p>\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Results:\u00a0<\/strong>Between 2011 and 2016, 96 patients (out of 200 planned) were randomised in WIN-Lupus: IST continuation group (n=48), IST discontinuation group (n=48). Relapse of proliferative LN occurred in 5\/40 (12.5%) patients with IST continuation and in 12\/44 (27.3%) patients with IST discontinuation (difference 14.8% (95% CI -1.9 to 31.5)). Non-inferiority was not demonstrated for relapse rate; time to relapse did not differ between the groups. Severe SLE flares (renal or extrarenal) were less frequent in patients with IST continuation (5\/40 vs 14\/44 patients; p=0.035). Adverse events did not differ between the groups.<\/p>\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Conclusions:\u00a0<\/strong>Non-inferiority of maintenance IST discontinuation after 2\u20123 years was not demonstrated for renal relapse. IST discontinuation was associated with a higher risk of severe SLE flares.<\/p>\r\n<\/div>[:]","paragraphe_en":"[:fr]<h2 class=\"title\" style=\"text-align: justify;\">Abstract<\/h2>\r\n<div id=\"eng-abstract\" class=\"abstract-content selected\">\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Objectives:\u00a0<\/strong>Lupus nephritis (LN) is a frequent complication of systemic lupus erythematosus (SLE). Severe (proliferative) forms of LN are treated with induction immunosuppressive therapy (IST), followed by maintenance IST, to target remission and avoid relapses. The optimal duration of maintenance IST is unknown. The WIN-Lupus trial tested whether IST discontinuation after 2\u20123 years was non-inferior to IST continuation for two more years in proliferative LN.<\/p>\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Methods:\u00a0<\/strong>WIN-Lupus was an investigator-initiated multicentre randomised controlled trial. Patients receiving maintenance IST with azathioprine or mycophenolate mofetil for 2-3 years, and hydroxychloroquine, were randomised (1:1) into two groups: (1) IST continuation and (2) IST discontinuation. The primary endpoint was the relapse rate of proliferative LN at 24 months. Main secondary endpoints were the rate of severe SLE flares, survival without renal relapse or severe flare, adverse events.<\/p>\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Results:\u00a0<\/strong>Between 2011 and 2016, 96 patients (out of 200 planned) were randomised in WIN-Lupus: IST continuation group (n=48), IST discontinuation group (n=48). Relapse of proliferative LN occurred in 5\/40 (12.5%) patients with IST continuation and in 12\/44 (27.3%) patients with IST discontinuation (difference 14.8% (95% CI -1.9 to 31.5)). Non-inferiority was not demonstrated for relapse rate; time to relapse did not differ between the groups. Severe SLE flares (renal or extrarenal) were less frequent in patients with IST continuation (5\/40 vs 14\/44 patients; p=0.035). Adverse events did not differ between the groups.<\/p>\r\n<p style=\"text-align: justify;\"><strong class=\"sub-title\">Conclusions:\u00a0<\/strong>Non-inferiority of maintenance IST discontinuation after 2\u20123 years was not demonstrated for renal relapse. IST discontinuation was associated with a higher risk of severe SLE flares.<\/p>\r\n<\/div>[:]","documents":null},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial - CRI<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cri1149.fr\/publication\/weaning-of-maintenance-immunosuppressive-therapy-in-lupus-nephritis-win-lupus-results-of-a-multicentre-randomised-controlled-trial\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial - 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