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Lupus nephritis

challenges and progress

Davidson, Anne; Aranow, Cynthia; Mackay, Meggan

Current Opinion in Rheumatology: November 2019 - Volume 31 - Issue 6 - p 682–688
doi: 10.1097/BOR.0000000000000642
SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana Kaplan
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Purpose of review The management of lupus nephritis remains unsatisfactory due to insufficiently effective treatment regimens and the dearth of reliable predictors of disease onset or progression to guide individualized therapeutic decisions. This review summarizes new findings related to lupus nephritis over the last 18 months and discusses clinical needs that should be considered to advance trials of mechanism-based therapeutic strategies.

Recent findings Collaborative teams are addressing how to improve disease definitions and are developing predictive models for disease onset, disease response and risk of flare in individual patients. More attention is being paid to clinical trial design. Advanced technologic approaches are allowing the analysis of small amounts of human tissue and urine in unprecedented detail so as to discover new pathogenic mechanisms and identify disease biomarkers. Novel therapies continue to be tested in disease models and include new strategies to protect renal tissue from cell damage and fibrosis.

Summary The collaborative efforts of patients, clinical and translational researchers, the pharmaceutical industry and funding sources are needed to advance therapies for lupus nephritis. Specialized clinical centers can then deliver optimal and more personalized patient care that will improve patient outcomes.

Center for Autoimmunity, Musculoskeletal and Hematologic Diseases, Feinstein Institute for Medical Research, New York, New York, USA

Correspondence to Anne Davidson, Center for Autoimmunity, Musculoskeletal and Hematologic Diseases, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, New York, NY 11030, USA. Tel: +1 516 562 3840; fax: +1 516 562 2953; e-mail: adavidson1@northwell.edu

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