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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Summary: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.
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Gabriella Moroni and Andrea Doria contributed equally to this manuscript.
ISSN:1462-0324
1462-0332
1462-0332
DOI:10.1093/rheumatology/keaa381