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Observational Study
. 2021 Aug:229:108781.
doi: 10.1016/j.clim.2021.108781. Epub 2021 Jun 16.

Improvement of renal and non-renal SLE outcome measures on sirolimus therapy - A 21-year follow-up study of 73 patients

Paramarajan Piranavan  1 , Andras Perl  2
Affiliations
Observational Study

Improvement of renal and non-renal SLE outcome measures on sirolimus therapy - A 21-year follow-up study of 73 patients

Paramarajan Piranavan et al. Clin Immunol. 2021 Aug.

Abstract

The safety, tolerance, and selected renal and non-renal outcome measures were evaluated in 73 SLE patients who received sirolimus therapy for more than 3 months in our institution over the past 21 years. In 12 patients who had lupus nephritis, proteinuria (p = 0.0287), hematuria (p = 0.0232), anti-DNA antibody levels (p = 0.0028) and steroid use were reduced (p = 0.0200). In the non-renal cohort of 61 patients, anti-DNA antibody levels (p = 0.0332) and steroid use were reduced (p = 0.0163). Both in the renal and non-renal cohorts, C3 (renal p = 0.0070; non-renal p = 0.0021) and C4 complement levels were increased (renal p = 0.0063; non-renal p = 0.0042) Adverse effects of mouth sores (2/73), headaches (1/73), and gastrointestinal discomfort were noted in a minority of patients (6/73). Sirolimus was only discontinued in two of 73 patients due to headache and recurrent infections, respectively. This study suggests that sirolimus is well tolerated and exerts long-term therapeutic efficacy in controlling renal and non-renal manifestations of SLE.

Keywords: Nephritis; Rapamycin; Sirolimus; Systemic lupus erythematosus; mTOR.

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Figures

Figure 1.
Figure 1.
Longitudinal changes in proteinuria (urine protein/creatinine ratio in mg/mg) in twelve patients who received sirolimus therapy.
See this image and copyright information in PMC

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