Hydroxychloroquine use and blood pressure below 130/80 are associated with remission in lupus nephritis: A cohort study: El uso de hidroxicloroquina y las cifras de presión arterial por debajo de 130/80 se asocian con remisión en nefritis lúpica: un estudio de cohorte

Introduction: The treatment of lupus nephritis, in addition to immunosuppression, includes the use of adjuvant therapies (antimalarials, statins, blockade of the renin–angiotensin system, and the achievement of blood pressure levels below 130/80). The evidence for the use of these strategies comes from non-autoimmune primary glomerulopathies and there is no information on their impact on the remission of this condition. Objective: To determine, in patients with lupus nephritis, the use of adjuvant therapies and their association with remission at 12 months. Materials and methods: A retrospective cohort study was conducted, between 2005 and 2012. Patients who achieved complete remission of nephritis were compared with those who did not. Complete remission was defined by the American College of Rheumatology AdHoc Subcommittee. Outcomes: Percentage of use of adjuvant therapies. Bivariate and multivariate analysis were performed to define association with remission. Results: 167 subjects were included (all eligible subjects); 85.6% used antimalarials, 65.5% angiotensin converting enzyme inhibitors, 33.5% angiotensin receptor blockers, 30.7% dual blockade, 29.3% statins, and 85% achieved the goal blood pressure. In the multivariate analysis, the use of hydroxychloroquine (OR = .149; 95% CI: .034–.647; p = .003) and the achievement of goal blood pressure (OR = .248; 95% CI: .1–.615; p = .003) were associated with remission. Conclusions: In a cohort of patients with lupus nephritis, the use of hydroxychloroquine and achieving blood pressure values lower than 130/80 were associated with remission at 12 months.