The treatment of lupus nephritis, between consolidated strategies and new therapeutic options : a narrative review
Copyright by Società Italiana di Nefrologia SIN, Rome, Italy..
Over a half of patients with Systemic Lupus Erythematosus will develop lupus nephritis (LN). The diagnosis of LN, suspected based on clinical data (proteinuria, active urinary sediment, renal dysfunction), is confirmed with renal biopsy. The immunosuppressive treatment of proliferative classes of LN is based on an induction phase, where high-dose steroids are used in conjunction with mycophenolate mofetil (MMF) or cyclophosphamide, and a subsequent maintenance phase, that combines low-dose steroids with MMF or azathioprine. Different classes of drugs (calcineurin inhibitors, anti-CD20) can be used as an alternative, or in resistant forms of LN, although their role is less well-established. Recently published (or nearing completion) studies have opened up the possibility of using new drugs in LN. In particular, depletion (Obinutuzumab, anti-CD20 monoclonal antibody) or neutralization (Belimumab, anti-"B-cell activating factor" monoclonal antibody) of B lymphocytes, and the use of a calcineurin inhibitor with a low profile of renal and systemic toxicity (Voclosporin) demonstrated an improvement in renal response in addition to standard therapy.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia - 38(2021), 4 vom: 30. Aug. |
| Sprache: |
Italienisch |
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| Beteiligte Personen: |
Fontana, Francesco [VerfasserIn] |
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| Themen: |
8N3DW7272P |
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| Anmerkungen: |
Date Completed 25.10.2021 Date Revised 25.10.2021 published: Electronic Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM330116444 |
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| 520 | |a Copyright by Società Italiana di Nefrologia SIN, Rome, Italy. | ||
| 520 | |a Over a half of patients with Systemic Lupus Erythematosus will develop lupus nephritis (LN). The diagnosis of LN, suspected based on clinical data (proteinuria, active urinary sediment, renal dysfunction), is confirmed with renal biopsy. The immunosuppressive treatment of proliferative classes of LN is based on an induction phase, where high-dose steroids are used in conjunction with mycophenolate mofetil (MMF) or cyclophosphamide, and a subsequent maintenance phase, that combines low-dose steroids with MMF or azathioprine. Different classes of drugs (calcineurin inhibitors, anti-CD20) can be used as an alternative, or in resistant forms of LN, although their role is less well-established. Recently published (or nearing completion) studies have opened up the possibility of using new drugs in LN. In particular, depletion (Obinutuzumab, anti-CD20 monoclonal antibody) or neutralization (Belimumab, anti-"B-cell activating factor" monoclonal antibody) of B lymphocytes, and the use of a calcineurin inhibitor with a low profile of renal and systemic toxicity (Voclosporin) demonstrated an improvement in renal response in addition to standard therapy | ||
| 650 | 4 | |a Journal Article | |
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