{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:13:13Z","timestamp":1782299593377,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"unspecified","delay-in-days":145,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015866","name":"Hezkuntza, Hizkuntza Politika Eta Kultura Saila, Eusko Jaurlaritza","doi-asserted-by":"publisher","award":["IT 1512-22"],"award-info":[{"award-number":["IT 1512-22"]}],"id":[{"id":"10.13039\/100015866","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,5,9]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the efficacy and toxicity of the Lupus-Cruces Nephritis (LCN) protocol compared with standard of care (SOC) with cyclophosphamide (CYC) or mycophenolate in patients with lupus nephritis (LN) during an extended follow-up time up to 10 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with biopsy-proven class III, IV or V LN treated with LCN were compared with SOC. Patients in the LCN were treated with a CYC plus repeated methylprednisolone pulse-based regimen. The achievement of complete renal response (CRR) and the progression to chronic kidney disease (CKD) were the two main outcomes. Glucocorticoid (GC)-related toxicity, major infections and damage accrual were also analysed. A propensity score (PS)-adjusted multivariate analysis was used to overcome the confounding-by-indication bias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>147 patients were included in this study (47 LCN and 100 SOC). CRR at 12 months was 85% vs 44%, respectively (p&lt;0.001). Eventually, 96% patients in the LCN group achieved CRR vs 74% patients in the SOC (p=0.002). In the multivariate PS-adjusted Cox model, LCN patients were more likely to eventually achieve CRR (PS-adjusted HR 3.5, 95%\u2009CI 2.2 to 5.5, p&lt;0.001). The risk of progression to CKD was lower in LCN patients (PS-adjusted HR 0.3, 95%\u2009CI 0.11 to 0.82, p=0.019). The risks of GC-induced toxicity, renal or GC-related damage accrual and major infections were also lower in the LCN group: adjusted HR 0.09, 95%\u2009CI 0.02 to 0.39; PS-adjusted HR 0.14, 95%\u2009CI 0.04 to 0.4; PS-adjusted HR 0.2, 95%\u2009CI 0.046 to 0.95; respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study confirms the LCN protocol as an effective and safe, in addition to widely available and affordable, regimen for the induction therapy of LN.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/lupus-2025-001562","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T01:35:19Z","timestamp":1748309719000},"page":"e001562","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Long-term efficacy and safety of the Lupus-Cruces Nephritis protocol: a propensity score study of the Lupus-Cruces and Lupus-Bordeaux cohorts"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7788-1043","authenticated-orcid":false,"given":"Guillermo","family":"Ruiz-Irastorza","sequence":"first","affiliation":[{"name":"Autoimmune Diseases, Instituto de Investigaci\u00f3n Sanitaria Biobizkaia, Barakaldo, Spain"},{"name":"Euskal Herriko Unibertsitatea, Medikuntza eta Erizaintza Fakultatea, Leioa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1007-5378","authenticated-orcid":false,"given":"Beatriz","family":"Mar\u00edn-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Autoimmune Diseases, Instituto de Investigaci\u00f3n Sanitaria Biobizkaia, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8256-9353","authenticated-orcid":false,"given":"Luis","family":"Due\u00f1a-Bartolom\u00e9","sequence":"additional","affiliation":[{"name":"Autoimmune Diseases, Instituto de Investigaci\u00f3n Sanitaria Biobizkaia, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8378-8638","authenticated-orcid":false,"given":"Diana","family":"Paredes Ruiz","sequence":"additional","affiliation":[{"name":"Autoimmune Diseases, Instituto de Investigaci\u00f3n Sanitaria Biobizkaia, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9842-1553","authenticated-orcid":false,"given":"Amaia","family":"Osorio","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Cruces University Hospital, Barakaldo, 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