%0 Journal Article
%T Anti-dsDNA IgE: a potential non-invasive test for prediction of lupus nephritis relapse.
%A Himbert M
%A Jourde-Chiche N
%A Chapart L
%A Charles N
%A Baumstarck K
%A Daugas E
%J RMD Open
%V 10
%N 2
%D 2024 Jun 28
%M 38942591
%F 5.806
%R 10.1136/rmdopen-2024-004255
%X <B>OBJECTIVE: </B>Discontinuation or continuation of maintenance immunosuppressive therapy (MIST) after a severe lupus nephritis (LN) requires measuring the risk of relapse but reliable clinical and biological markers are lacking. The WIN-IgE study assesses the value of serum anti-dsDNA IgE autoantibodies as a biomarker for the prediction of relapse in severe LN.<BR><B>METHODS: </B>WIN-IgE is an ancillary study of the WIN-Lupus study (NCT01284725), a prospective controlled clinical trial which evaluated the discontinuation of MIST after 2-3 years in class III or IV±V LN with active lesions. WIN-IgE included all patients with available serum collected at randomisation for continuation or discontinuation of MIST. In these sera, anti-dsDNA antibodies, IgE and IgG, were quantified by ELISA and compared between patients who experienced LN relapse and those who did not during the 24 months of follow-up.<BR><B>RESULTS: </B>52 patients were included, 25 in the MIST continuation group and 27 in the MIST discontinuation group, 12 experienced a biopsy-proven relapse of LN. Initial anti-dsDNA IgE antibodies levels were higher in patients with subsequent LN relapse. Anti-dsDNA IgG was not associated with relapse. Survival without LN relapse was lower in patients with anti-dsDNA IgE levels above vs below a threshold of 1.9 arbitrary units (p=0.019), particularly in the subgroup of patients randomised to discontinue MIST (p=0.002). In all patients, anti-dsDNA IgE above 1.9 arbitrary units had a positive predictive value of 0.8 for severe LN relapse.<BR><B>CONCLUSIONS: </B>These results suggest blood anti-dsDNA IgE as a non-invasive predictive marker of LN relapse.