News and Views From Latin AmericaControversies in Systemic Lupus Erythematosus 2021 Changing the Paradigm in the Management of Lupus NephritisPorta, Sabrina Valeria MD∗; Enfrein, Antoine MD†; Houssiau, Frédéric MD, PhD‡,§; García, Mercedes MD∥; Furie, Richard MD¶; Rovin, Brad H. MD#; Alarcón, Graciela S. MD, MPH∗∗,††; Pons-Estel, Bernardo A. MD, PhD, MACR‡‡; Pons-Estel, Guillermo J. PhD, MD‡‡ Author Information From the ∗Rheumatology Department, Carlos G. Durand Hospital, Buenos Aires, Argentina †Internal Medicine Department, Centre Hospitalier Universitaire de Nantes, Nantes, France ‡Pôle de Pathologies Rhumatismales Inflammatoires et Systémiques, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain §Rheumatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium ∥Rheumatology Department, Hospital Interzonal General de Agudos San Martin de La Plata, La Plata, Argentina ¶Division of Rheumatology, Northwell Health, Great Neck, NY #Division of Nephrology, Ohio State University Wexner Medical Center, Columbus, OH ∗∗Division of Rheumatology and Clinical Immunology, The University of Alabama at Birmingham, Birmingham, AL ††Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú ‡‡Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina. S.V.P., A.E., M.G., B.A.P.-E., and G.S.A have no conflicts of interest to declare. R.F. has received consulting fees from GSK and Aurinia Pharmaceuticals. F.H. has received consultant fees from GSK, Astra-Zeneca, and Idorsia. B.H.R. has received consulting fees from GSK and Aurinia Pharmacetuicals. G.J.P.-E. is a speaker, is a consultant, and received grants from Pfizer, Janssen, GSK, Sandoz, and Sanofi. Author contributions: S.V.P., A.E., F.H., M.G., R.F., B.H.R., G.J.P.-E., and G.S.A. contributed to the writing of the original draft. B.A.P.-E., G.P.-E., and G.S.A. contributed to the supervision. G.P.E. and G.S.A. contributed to the review and editing—grammar, style, and language. All authors contributed to the article and approved the submitted version. This research received no external funding. Correspondence: Guillermo J. Pons-Estel, PhD, MD, Hospital Clinic de Barcelona, Barcelona, GO-CREAR (Centro Regional Enfermedades Autoinmunes y Reumáticas) CP 2000. Rosario, Argentina, Spain. E-mail: [email protected]. JCR: Journal of Clinical Rheumatology 28(4):p 229-233, June 2022. | DOI: 10.1097/RHU.0000000000001859 Buy Metrics Abstract Lupus nephritis (LN) affects about a third of patients with systemic lupus erythematosus. Although the use of conventional therapy has significantly improved the prognosis of LN, the response to treatment remains suboptimal, with high rates of relapse and the occurrence of end-stage kidney disease. The implementation of new diagnostic and treatment strategies aimed at improving these outcomes represents a necessary paradigm shift in the management of LN. Herein, we discuss different points of view regarding these still unresolved issues; these comments represent a debate that took place during the virtual congress of the Pan American League of Associations for Rheumatology (PANLAR) and which was organized by the PANLAR Lupus Study Group, GLADEL (Grupo Latino Americano De Estudio del Lupus) on August 15, 2021. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.