Margherita Z, Enrico F, Marta LM, et al. - Researchers examined the rate as well as predictors of flare following immunosuppressive therapy (IS) withdrawal in patients with lupus nephritis (LN) in remission. This analysis involved patients with biopsy-confirmed LN managed with IS between 1980 and 2020. Of 513 SLE patients incorporated in the database, 270 had LN. Of these, 238 had renal biopsy and were managed with ISs. A mean±SD follow-up of 116.5 ± 78 months revealed occurrence of a flare (8/19 renal) in 19 patients (22.8%) and these patients were re-treated; 14/19 (73.7%) re-achieved remission post-reinitiating therapy. The lowest risk of relapse was observed in patients managed with IS therapy for at least three years post-remission achievement. In multivariate analysis, the factors that were protective against disease flares were: antimalarial maintenance therapy, age at IS discontinuation, and remission duration >3 years before IS discontinuation. Overall, findings demonstrate the feasibility of IS withdrawal in LN patients in remission for at least 3 years and receiving antimalarial therapy. An appropriate treatment can provide re-achievement of remission in patients who experience flares.