Comparison between Standard of Care Treatment and Dapagliflozin Added to Standard of Care in Patients with Lupus Nephritis: A Randomized Controlled Trial

Background: The exploration of sodium-glucose cotransporter-2 inhibitors (SGLT-2i) presents a novel avenue in treating Lupus Nephritis (LN). This study investigates the potential role of adding Dapagliflozin to the SOC treatment in management of LN patients. Methods: We conducted a randomised controlled open-label study by enrolling 32 newly diagnosed LN patients. Among them, 17 received Dapagliflozin in addition to SOC, while 15 received SOC alone. The patients were followed up monthly for 6 months. The primary outcome was the treatment response at 6 months as per the KDIGO guidelines. Results: Baseline characteristics revealed no significant demographic differences between the two groups. While both groups exhibited prevalent lupus-related symptoms, the intervention group demonstrated significantly lower mean systolic blood pressure and total protein levels at baseline. At the 6-month follow-up, the clinical response rate in the intervention group was 81.8%, with a trend toward better outcomes compared to the standard of care group (60%) (p 0.425). Frequency of urinary tract infections was higher in the dapagliflozin arm (p 0.31). No significant differences were observed in other parameters between the groups at the 6 months. Conclusion: In conclusion, this pilot study suggests that the addition of Dapagliflozin to standard care may improve clinical responses in LN with acceptable adverse effects.Figure 1: Consort DiagramTable 1: Baseline characteristics