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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
While rapid glucocorticoid (GC) tapering is increasingly advocated in proliferative lupus nephritis (LN), evidence regarding this approach in pure membranous LN (Class V) remains limited. Given the distinct pathophysiology and traditionally variable treatment strategies for Class V disease, the safety and efficacy of reducing GC to low doses within six months warrant clarification. We aimed to evaluate the impact of rapid GC tapering on renal outcomes in patients with biopsy-confirmed pure membranous LN.
This multicenter retrospective cohort study included patients with ISN/RPS Class V LN treated between 2003 and 2023 across 18 centers in Japan. Patients were categorized into a rapid tapering group (prednisolone ≤7.5 mg/day at six months) and a conventional tapering group (>7.5 mg/day). The primary endpoint was partial renal response (PRR) at 12 months. Secondary endpoints included complete renal response (CRR) at 12 and 24 months, relapse, and serious adverse events (SAEs). Adjusted risk ratios (aRRs) were estimated using modified Poisson regression, controlling for baseline proteinuria, estimated GFR, initial GC dose, and immunosuppressant use.
A total of 67 patients were analyzed (rapid-tapering group, n = 15; conventional-tapering group, n = 52), with no significant baseline differences in demographics, proteinuria, renal function, or concomitant immunosuppressive therapy. Early disease control was comparable, with ≥50% proteinuria reduction at 3 months in 75.0% of the rapid group and 57.4% of the conventional group (p = 0.334). At 12 months, partial renal response (PRR) was achieved in 85.7% vs 84.3% of the rapid and conventional groups, respectively (aRR 0.79; 95% CI 0.14–4.60), and complete renal response (CRR) in 64.3% vs 56.9%, respectively (aRR 0.68; 95% CI 0.29–1.60). At 24 months, both PRR (83.3% vs. 80.4%) and CRR (50.0% vs. 45.7%) remained comparable between the two groups after adjustment. Relapse occurred in 20.0% vs 7.7%, respectively (p = 0.185). Notably, no SAEs were observed in the rapid group, whereas three events (5.8%), including leukopenia and herpes zoster, occurred exclusively in the conventional group. These findings indicate that rapid tapering did not compromise disease control or safety.
Rapid tapering of GC to ≤7.5 mg/day within six months was not associated with worse renal response, increased relapse, nor increased toxicity in pure membranous LN. These findings suggest that rapid GC minimization may be a feasible strategy for Class V LN, extending the evidence previously demonstrated in proliferative disease. Prospective studies are warranted to confirm optimal tapering protocols and identify patients most likely to benefit.
