Τίτλος:
An Update on the Diagnosis and Management of Lupus Nephritis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose of Review: Update on the diagnosis, treatment, and monitoring of lupus nephritis. Recent Findings: The recent criteria enable the earlier classification of lupus nephritis based on kidney biopsy and compatible serology. Treatment of active nephritis includes low-dose intravenous cyclophosphamide or mycophenolate, followed by maintenance immunosuppression. Recent trials have suggested superiority of regimens combining mycophenolate with either calcineurin inhibitor or belimumab, although their long-term benefit/risk ratio has not been determined. Encouraging results with novel anti-CD20 antibodies confirm the effectiveness of B cell depletion. Achievement of low-grade proteinuria (< 700–800 mg/24 h) at 12-month post-induction is linked to favorable long-term outcomes and could be considered in a treat-to-target strategy. Also, repeat kidney biopsy can guide the duration of maintenance immunosuppression. Lupus nephritis has increased cardiovascular disease burden necessitating risk-reduction strategies. Summary: An expanding spectrum of therapies coupled with ongoing basic/translational research can lead to individualized medical care and improved outcomes in lupus nephritis. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Συγγραφείς:
Kostopoulou, M.
Adamichou, C.
Bertsias, G.
Περιοδικό:
Current Rheumatology Reports
Λέξεις-κλειδιά:
biological product; calcineurin inhibitor; immunosuppressive agent; cyclophosphamide; monoclonal antibody; mycophenolic acid, childhood disease; diagnostic procedure; disease burden; drug efficacy; drug safety; early diagnosis; end stage renal disease; human; immunosuppressive treatment; kidney biopsy; lupus erythematosus nephritis; maintenance therapy; patient care; patient monitoring; pregnancy disorder; relapse; Review, Antibodies, Monoclonal; Calcineurin Inhibitors; Cyclophosphamide; Humans; Immunosuppressive Agents; Lupus Nephritis; Mycophenolic Acid
DOI:
10.1007/s11926-020-00906-7
