Lupus nephritis: clinical presentations and outcomes in the 21st century

Abstract Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been changing. However, even though retrospective cohort studies report a decreased mortality rate and an improvement in the disease prognosis, th...

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Published inRheumatology (Oxford, England) Vol. 59; no. Supplement_5; pp. v39 - v51
Main Authors Gasparotto, Michela, Gatto, Mariele, Binda, Valentina, Doria, Andrea, Moroni, Gabriella
Format Journal Article
LanguageEnglish
Published England Oxford University Press 05.12.2020
Subjects
Disease Progression
Humans
Lupus Nephritis - classification
Lupus Nephritis - diagnosis
Lupus Nephritis - pathology
Lupus Nephritis - therapy
Prognosis
Recurrence
Remission Induction
Risk Factors
Supplement Papers
risk factors
renal biopsy
lupus nephritis
B cells
classification
prognosis
calcineurin inhibitors
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Abstract Abstract Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been changing. However, even though retrospective cohort studies report a decreased mortality rate and an improvement in the disease prognosis, the percentage of patients progressing into end stage renal disease (ESRD) keeps steady despite the improvements in therapeutic strategies. Current in-use medications have been available for decades now, yet over the years, regimens for optimizing their efficacy and minimizing toxicity have been developed. Therapeutic research is now moving towards the direction of precision medicine and several new drugs, targeting selectively different pathogenetic pathways, are currently under evaluation with promising results. In this review, we address the main changes and persistent unmet needs in LN management throughout the past decades, with a focus on prognosis and upcoming treatments.
AbstractList Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been changing. However, even though retrospective cohort studies report a decreased mortality rate and an improvement in the disease prognosis, the percentage of patients progressing into end stage renal disease (ESRD) keeps steady despite the improvements in therapeutic strategies. Current in-use medications have been available for decades now, yet over the years, regimens for optimizing their efficacy and minimizing toxicity have been developed. Therapeutic research is now moving towards the direction of precision medicine and several new drugs, targeting selectively different pathogenetic pathways, are currently under evaluation with promising results. In this review, we address the main changes and persistent unmet needs in LN management throughout the past decades, with a focus on prognosis and upcoming treatments.Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been changing. However, even though retrospective cohort studies report a decreased mortality rate and an improvement in the disease prognosis, the percentage of patients progressing into end stage renal disease (ESRD) keeps steady despite the improvements in therapeutic strategies. Current in-use medications have been available for decades now, yet over the years, regimens for optimizing their efficacy and minimizing toxicity have been developed. Therapeutic research is now moving towards the direction of precision medicine and several new drugs, targeting selectively different pathogenetic pathways, are currently under evaluation with promising results. In this review, we address the main changes and persistent unmet needs in LN management throughout the past decades, with a focus on prognosis and upcoming treatments.
Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been changing. However, even though retrospective cohort studies report a decreased mortality rate and an improvement in the disease prognosis, the percentage of patients progressing into end stage renal disease (ESRD) keeps steady despite the improvements in therapeutic strategies. Current in-use medications have been available for decades now, yet over the years, regimens for optimizing their efficacy and minimizing toxicity have been developed. Therapeutic research is now moving towards the direction of precision medicine and several new drugs, targeting selectively different pathogenetic pathways, are currently under evaluation with promising results. In this review, we address the main changes and persistent unmet needs in LN management throughout the past decades, with a focus on prognosis and upcoming treatments.
Abstract Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been changing. However, even though retrospective cohort studies report a decreased mortality rate and an improvement in the disease prognosis, the percentage of patients progressing into end stage renal disease (ESRD) keeps steady despite the improvements in therapeutic strategies. Current in-use medications have been available for decades now, yet over the years, regimens for optimizing their efficacy and minimizing toxicity have been developed. Therapeutic research is now moving towards the direction of precision medicine and several new drugs, targeting selectively different pathogenetic pathways, are currently under evaluation with promising results. In this review, we address the main changes and persistent unmet needs in LN management throughout the past decades, with a focus on prognosis and upcoming treatments.
Author Moroni, Gabriella
Gasparotto, Michela
Gatto, Mariele
Binda, Valentina
Doria, Andrea
AuthorAffiliation 1 Rheumatology Unit, Department of Medicine, University of Padua
2 Nephrology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan, Italy
AuthorAffiliation_xml – name: 1 Rheumatology Unit, Department of Medicine, University of Padua
– name: 2 Nephrology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan, Italy
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  organization: Rheumatology Unit, Department of Medicine, University of Padua
– sequence: 2
  givenname: Mariele
  surname: Gatto
  fullname: Gatto, Mariele
  organization: Rheumatology Unit, Department of Medicine, University of Padua
– sequence: 3
  givenname: Valentina
  surname: Binda
  fullname: Binda, Valentina
  organization: Nephrology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
– sequence: 4
  givenname: Andrea
  orcidid: 0000-0003-0548-4983
  surname: Doria
  fullname: Doria, Andrea
  email: adoria@unipd.it
  organization: Rheumatology Unit, Department of Medicine, University of Padua
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  givenname: Gabriella
  surname: Moroni
  fullname: Moroni, Gabriella
  organization: Nephrology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33280015$$D View this record in MEDLINE/PubMed
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Copyright The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. 2020
The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.
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Issue Supplement_5
Keywords risk factors
renal biopsy
lupus nephritis
B cells
classification
prognosis
calcineurin inhibitors
Language English
License This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
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The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.
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content type line 23
Gabriella Moroni and Andrea Doria contributed equally to this manuscript.
ORCID 0000-0003-0548-4983
OpenAccessLink https://dx.doi.org/10.1093/rheumatology/keaa381
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PublicationTitle Rheumatology (Oxford, England)
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Snippet Abstract Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been...
Lupus nephritis (LN) is a frequent and severe manifestation of SLE. Along the decades, the epidemiology of LN and its clinical presentation have been changing....
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SubjectTerms Disease Progression
Humans
Lupus Nephritis - classification
Lupus Nephritis - diagnosis
Lupus Nephritis - pathology
Lupus Nephritis - therapy
Prognosis
Recurrence
Remission Induction
Risk Factors
Supplement Papers
Title Lupus nephritis: clinical presentations and outcomes in the 21st century
URI https://www.ncbi.nlm.nih.gov/pubmed/33280015
https://www.proquest.com/docview/2467847708
https://pubmed.ncbi.nlm.nih.gov/PMC7751166
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