WIN-Lupus (Weaning of Maintenance Immunosuppressive Therapy in Lupus Nephritis) is a multicenter, randomized controlled trial designed to evaluate whether it is safe to discontinue maintenance immunosuppressive therapy (IST) in patients with Lupus Nephritis (LN) who are in remission. Key Aspects of the WIN-Lupus Trial:
Purpose: The study sought to determine if stopping maintenance treatment (azathioprine or mycophenolate mofetil) after 2–3 years of remission was non-inferior to continuing the treatment for another two years.
Participants: The trial included adults (≥18 years) with biopsy-proven proliferative LN, who had been in complete or partial renal remission for at least 12 months, and were taking low-dose prednisone (≤10 mg/day) and hydroxychloroquine.
Study Design: Conducted between February 2011 and December 2018 across 28 centers in France, it was a parallel-arm, non-inferiority study.
Results: The trial found that discontinuing IST was not non-inferior to continuing it. Patients who stopped treatment had a higher risk of severe Systemic Lupus Erythematosus (SLE) flares.
Conclusion: While stopping medication carries a higher risk of flare, the study also demonstrated that a significant portion of patients who discontinued IST did not experience a flare, indicating the need to better identify patients for whom weaning is safe.
The findings emphasize that while maintenance therapy should not be universally stopped, some patients with stable, long-term remission might safely discontinue treatment.
If you’re interested, I can also look for more information on the specific criteria for successful weaning or follow-up studies to this trial.
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results of a multicentre randomised controlled trial – PubMed
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