Lupus Nephritis

Although recent clinical data continue to expand possible treatment options for lupus nephritis, whether belimumab or voclosporin should be the first-line therapy remained hotly contested during the ACR’s annual Great Debate.

Rheumatologists opt for therapy regimens that include rituximab more often than nephrologists in treating refractory lupus nephritis or renal flare in children, according to data published in Pediatric Rheumatology.

For children and adolescents initiating dialysis, lupus nephritis conferred a higher hospitalization risk, as well as a lower likelihood of transplantation, compared with other glomerular causes of end-stage kidney disease.

The recent approval of anifrolumab highlights what may be a new wave of therapeutic advances made in lupus, according to a presenter at the 2021 Congress of Clinical Rheumatology-East.

Managing cardiovascular event risk is critical to preventing morbidity and mortality in lupus nephritis, especially among groups at increased risk for the disease, according to a speaker at the 2021 Rheumatology Nurses Society annual conference.

In the 10 years since its first FDA approval for systemic lupus erythematosus in 2011, belimumab has altered the “SLE treatment paradigm,” amassing a body of evidence establishing it as a disease-modifying therapy, according to a review article.

Patients with childhood-onset lupus nephritis should receive up to three infusions of methylprednisolone at 30 mg/kg per dose upon diagnosis, with a maximum 60 mg of daily oral corticosteroids in the first 4 weeks, according to researchers.

Voclosporin, when added to mycophenolate mofetil and low-dose steroids, results in higher complete renal response rates in patients with lupus nephritis, compared with mycophenolate mofetil and low-dose steroids alone, according to data.

Patients with lupus nephritis who received voclosporin maintained “meaningful” reductions in proteinuria, with stable mean estimated glomerular filtration rates, at 2 years, according to a poster session at the EULAR 2021 Virtual Congress.

Adding the calcineurin inhibitor voclosporin to the standard of care was effective in treating lupus nephritis across all biopsy classes, according to pooled data from the AURA-LV and AURORA trials.