Trial reportThe Journal of rheumatology2026
The Renal Activity Index for Lupus: Validation for Prediction of Kidney Inflammation in Adult Patients With Lupus Nephritis.
Trial report in The Journal of rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01714817 (A Phase 3 Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of BMS-188667), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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A Phase 3 Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of BMS-188667 (Abatacept) or Placebo on a Background of Mycophenolate Mofetil and Corticosteroids in the Treatment of Subjects With Active Class III or IV Lupus Nephritis
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo evaluate the ability of the Renal Activity Index for Lupus (RAIL) score, a urine biomarker-derived score, to capture and predict the course of active lupus nephritis (LN) in adult patients.
methodsAvailable serial urine samples collected up to week 52 from a subset of adults with active biopsy-proven proliferative LN participating in the double-blind randomized ALLURE trial of abatacept (ClinicalTrials.gov: NCT01714817) were used to calculate RAIL scores from creatinine-adjusted urine biomarkers (neutrophil gelatinase-associated lipocalin [NGAL], kidney injury molecule 1 [KIM-1], monocyte chemotactic protein 1 [MCP-1], adiponectin, hemopexin, ceruloplasmin). Discriminative performance of RAIL scores alone over time were compared with urine protein/creatinine ratio (UPCR), kidney function (estimated glomerular filtration rate [eGFR]), and mixed model analysis of RAIL score adjusted for baseline UPCR, eGFR, age, weight, sex, and race, with comparisons by renal response states including complete renal response (CRR), partial renal response but not CRR (PRR-only), and nonresponse (NR).
resultsThe analysis included 240 patients who contributed 599 samples. At weeks 12/24/52, there were 44/22/15 patients with PRR-only, 27/33/18 with CRR, and 127/61/15 NR. RAIL scores, eGFR, and UPCR improved over time irrespective of abatacept use, but were significantly lower with CRR compared to NR. The eGFR alone had poor accuracy (area under the receiver-operating characteristic curve [AUC] < 0.51) to discriminate renal response. Only after correction of baseline UPCR and eGFR, the RAIL score had excellent accuracy to reflect CRR from other renal response states at the current (AUC = 0.83-0.84) and next visit (AUC = 0.84-0.85) and performed better than UPCR; without correction, UPCR and RAIL score had similarly good accuracy.
conclusionRAIL scores identify active LN and longitudinally predict the course of adult LN. (ClinicalTrials.gov: NCT01714817).
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