PLoS ONE (Jan 2018)

Renal protective effect of antiplatelet therapy in antiphospholipid antibody-positive lupus nephritis patients without antiphospholipid syndrome.

  • Hironari Hanaoka,
  • Harunobu Iida,
  • Tomofumi Kiyokawa,
  • Yukiko Takakuwa,
  • Takahiro Okazaki,
  • Hidehiro Yamada,
  • Shoichi Ozaki,
  • Kimito Kawahata

DOI
https://doi.org/10.1371/journal.pone.0196172
Journal volume & issue
Vol. 13, no. 5
p. e0196172

Abstract

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We sought to evaluate the effect of antiplatelet therapy in addition to conventional immunosuppressive therapy for lupus nephritis (LN) patients positive for antiphospholipid antibodies (aPL) without definite antiphospholipid syndrome (APS).Patients with biopsy-proven LN class III or IV were retrospectively evaluated. We selected patients positive for anticardiolipin antibody (aCL) or lupus anticoagulant (LA) who did not meet the criteria for a diagnosis of APS. The patients were divided into two subgroups according to whether antiplatelet therapy was received. The cumulative complete renal response (CR) rate, relapse-free rate, and change in estimated glomerular filtration rate (eGFR) over 3 years after induction therapy were calculated.We identified 17 patients who received antiplatelet therapy and 21 who did not. Baseline clinicopathological characteristics and immunosuppressive therapy did not show a significant difference between the two groups except for a higher incidence of LN class IV in the treatment group (p = 0.03). There was no difference in cumulative CR rate, relapse-free rate, or eGFR change between these subgroups. However, when data on LA-positive patients were assessed, an improvement in eGFR was found (p = 0.04) in patients receiving antiplatelet treatment.Addition of anti-platelet therapy was associated with an improvement of eGFR in LA-positive patients with LN class III or IV.