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Management of lupus nephritis has evolved considerably over the past years. Here, we provide a comprehensive review of clinical trials that form the basis for the Kidney Disease: Improving Global Outcomes and EULAR/ERA-EDTA updated guidelines and present day trials that will change the landscape of lupus nephritis therapy in years to come. In addition, we highlight the issues related to cost of therapy, resistant disease, and downstream adverse effects of specific therapies.
R. Avasare reports the following: Advisory or Leadership Role: Editorial Board of Glomerular Disease Journal (Karger); and Other Interests or Relationships: Member of ASN, NKF. Site PI for the NEFIGARD study, TRIDENT study. Nephrology consultant for the LAPMS clinical trial (NCT03161028). D.J. Caster reports the following: Consultancy: Aurinia, Calliditas, Chinook, GSK, and Travere; Ownership Interest: Individual stock holdings in Coca-Cola and Procter and Gamble; Research Funding: PI on Industry Sponsored Clinical Trials sponsored by Alexion, Chinook, and Travere; Honoraria: Aurinia, Calliditas, Chinook, GSK, and Travere; Advisory or Leadership Role: Lupus Foundation of America Medical Scientific Advisory Counsel; Glomerular Diseases Editorial Board; Speakers Bureau: Aurinia, Calliditas, GSK; and Other Interests or Relationships: National Institutes of Health: NIH R01 1RO1DK126777. J.A. Jefferson reports the following: Research Funding: Novartis; and Honoraria: Uptodate. A. Mitrofanova reports the following: Other Interests or Relationships: –American Society of Nephrology, member; –American Heart Association, member. The remaining author has nothing to disclose.
Figures
Figure 1
Evolution of therapies for LN…
Figure 1
Evolution of therapies for LN and their targets: standard of care, new to…
Figure 1
Evolution of therapies for LN and their targets: standard of care, new to practice, and emerging therapies. BAFF, B-cell activating factor; CaN, calcineurin; CAR T-cell, chimeric antigen receptor T-cell; CD, cluster of differentiation; EC, endothelial cell; GBM, glomerular basement membrane; IL, interleukin; INF-1R, interferon alpha receptor 1; NFAT, nuclear factor of activated T-cells; TACI, transmembrane activator calcium modulator and cyclophilin ligand interactor; Th17, T helper 17 cell.
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