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lupus nephritis treatment

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https://www.readbyqxmd.com/read/29333701/the-childhood-arthritis-rheumatology-research-alliance-consensus-treatment-plans-towards-comparative-effectiveness-in-the-pediatric-rheumatic-diseases
#1
REVIEW
Sarah Ringold, Peter A Nigrovic, Brian M Feldman, George A Tomlinson, Emily von Scheven, Carol A Wallace, Adam M Huber, Laura E Schanberg, Suzanne C Li, Pamela F Weiss, Robert C Fuhlbrigge, Esi M Morgan, Yukiko Kimura
The pediatric rheumatic diseases are a heterogeneous group of rare diseases, posing a number of challenges for the use of traditional clinical and translational research approaches. Innovative comparative effectiveness approaches are needed to efficiently study treatment approaches and disease outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed the consensus treatment plan (CTP) approach as a comparative effectiveness tool for research in pediatric rheumatology. CTPs are treatment strategies, developed by consensus methods among CARRA members, intended to reduce variation in treatment approaches, standardize outcome measurements, and allow for comparison of the effectiveness of different approaches with the goal of improving disease outcomes...
January 15, 2018: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29321925/lupus-pneumonitis-presenting-with-high-titre-of-anti-ro-antibody
#2
Mei-Chuan Chen, Yueh-Lin Wu, Kai-Ling Lee, Kevin S Lai, Chi-Li Chung
Lupus pneumonitis carries high mortality and is a rare manifestation of systemic lupus erythematosus (SLE). However, it is difficult to diagnose and is often mistaken as pneumonia, alveolar haemorrhage, or organizing pneumonia. Previous studies demonstrated that serum anti-Ro antibodies are elevated more frequently in SLE patients with pneumonitis than in those without. We report a 21-year-old female who was newly diagnosed as having SLE with nephritis and who suddenly developed right lung opacity and rapidly progressed to severe hypoxaemia despite the use of broad-spectrum antibiotics...
January 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29319493/cyclosporine-for-the-treatment-of-lupus-nephritis-in-patients-with-systemic-lupus-erythematosus
#3
Tzu-Han Yang, Tsai-Hung Wu, Yuh-Lih Chang, Hsien-Tzung Liao, Chia-Chen Hsu, Chang-Youh Tsai, Yueh-Ching Chou
AIMS: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). MATERIALS AND METHODS: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded...
January 10, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29317407/a20-haploinsufficiency-ha20-clinical-phenotypes-and-disease-course-of-patients-with-a-newly-recognised-nf-kb-mediated-autoinflammatory-disease
#4
Florence A Aeschlimann, Ezgi D Batu, Scott W Canna, Ellen Go, Ahmet Gül, Patrycja Hoffmann, Helen L Leavis, Seza Ozen, Daniella M Schwartz, Deborah L Stone, Annet van Royen-Kerkof, Daniel L Kastner, Ivona Aksentijevich, Ronald M Laxer
OBJECTIVES: The association between mutations in TNFAIP3, encoding the NF-kB regulatory protein A20, and a new autoinflammatory disease has recently been recognised. This study aims at describing the clinical phenotypes and disease course of patients with A20 haploinsufficiency (HA20). METHODS: Data for all cases from the initial publication, and additional cases identified through collaborations since, were collected using standardised data collection forms. RESULTS: A total of 16 patients (13 female) from seven families with a genetic diagnosis of HA20 were included...
January 9, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29314776/chronicity-index-especially-glomerular-sclerosis-is-the-most-powerful-predictor-of-renal-response-following-immunosuppressive-treatment-in-patients-with-lupus-nephritis
#5
Dong-Jin Park, Sung-Eun Choi, Haimuzi Xu, Ji-Hyoun Kang, Kyung-Eun Lee, Ji Shin Lee, Yoo-Duk Choi, Shin-Seok Lee
AIM: Renal responses to immunosuppressive agents in patients with lupus nephritis (LN) differ depending on ethnicity, follow-up duration, disease severity and treatment. Thus, we evaluated predictors of complete remission during the first year following immunosuppressive treatment in patients with LN. METHODS: We retrospectively reviewed 79 patients who underwent kidney biopsy prior to the start of induction treatment and who were subsequently treated with immunosuppressive drugs for at least 6 months and followed-up for more than a year...
January 5, 2018: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29310419/proliferative-lupus-nephritis-in-the-absence-of-overt-systemic-lupus-erythematosus-a-historical-study-of-12-adult-patients
#6
Maxime Touzot, Cécile Saint-Pastou Terrier, Stanislas Faguer, Ingrid Masson, Hélène François, Lionel Couzi, Aurélie Hummel, Nathalie Quellard, Guy Touchard, Noémie Jourde-Chiche, Jean-Michel Goujon, Eric Daugas
Severe lupus nephritis in the absence of systemic lupus erythematosus (SLE) is a rare condition with an unclear clinical presentation and outcome.We conducted a historical observational study of 12 adult (age >18 years) patients with biopsy-proven severe lupus nephritis or lupus-like nephritis without SLE immunological markers at diagnosis or during follow-up. Excluded were patients with chronic infections with HIV or hepatitis B or C; patients with a bacterial infectious disease; and patients with pure membranous nephropathy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29299823/clinicopathological-study-of-male-and-female-patients-with-lupus-nephritis-a-retrospective-study
#7
Wei Peng, Yi Tang, Li Tan, Wei Qin
PURPOSE: The aim of this study was to assess the impact of sex on long-term outcomes in patients with lupus nephritis (LN). METHODS: Data of patients were collected at a single tertiary hospital from June 2010 to June 2016. Clinicopathological features and treatment responses of LN patients with different genders were compared. The primary endpoint was serum creatinine level doubled, GFR < 15 mL/min, initiation of renal replacement treatment or death. The secondary endpoint was complete remission or partial remission...
January 3, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29285480/comparison-study-on-the-effect-of-treatment-decision-based-on-renal-biopsy-and-clinical-symptoms-in-the-outcome-of-patients-with-recurrent-lupus-nephritis
#8
Hadi Karimzadeh, Shokrollah Hasani, Zahra Sayedbonakdar, Ali Mehrabi Koushki
Background: Renal involvement in systemic lupus erythematous is one of the most serious complications. The aim of this study was to compare the effects of treatment decisions based on clinical symptoms and renal biopsy on the outcome of patients with recurrent lupus nephritis. Materials and Methods: This descriptive study was conducted in 2012-13 in the Alzahra hospital on patients with lupus nephritis who had referred to the rheumatology clinic of this center due to lupus nephritis relapse...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29275837/plasticity-and-heterogeneity-of-th17-in-immune-mediated-kidney-diseases
#9
REVIEW
Christian F Krebs, Ulf Panzer
Anti-neutrophil cytoplasmatic antibody (ANCA)-associated glomerulonephritis, anti-glomerular basement membrane (GBM) glomerulonephritis and lupus nephritis are the most common causes of rapid progressive glomerulonephritis (RPGN) in the Western world. These aggressive forms of autoimmune kidney diseases significantly contribute to end-stage renal disease and are associated with high morbidity and mortality. Moreover, patients show significant heterogeneity with respect to clinical outcome and response to therapy...
December 21, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/29225917/role-of-p-glycoprotein-on-cd69-cd4-cells-in-the-pathogenesis-of-proliferative-lupus-nephritis-and-non-responsiveness-to-immunosuppressive-therapy
#10
Shizuyo Tsujimura, Tomoko Adachi, Kazuyoshi Saito, Yoshiya Tanaka
Introduction: P-glycoprotein (P-gp) expression on activated lymphocytes in systemic lupus erythematosus (SLE) plays a role in active efflux of intracellular drugs, resulting in drug resistance. The role of P-gp-expressing lymphocytes in the pathogenesis of SLE remains unclear. The aim of this study was to determine the importance of P-gp+CD4+ cells in organ manifestations in refractory SLE. Methods: The proportion of P-gp+CD4+ cells was determined by flow cytometry in peripheral blood of patients with SLE (n=116) and healthy adults (n=10)...
2017: RMD Open
https://www.readbyqxmd.com/read/29214037/correlation-of-hypogammaglobulinaemia-with-proteinuria-and-the-relationship-between-hypogammaglobulinaemia-and-infection-in-active-lupus-nephritis
#11
Dawn Elaine Smilek, Noha Lim, Linna Ding, Sara G Murray, Betty Diamond, David Wofsy
Objective: To evaluate hypogammaglobulinaemia and risk of serious infectious adverse events in active lupus nephritis. Methods: The Abatacept and Cyclophosphamide Combination Efficacy and Safety Study (ACCESS) compared abatacept with placebo in participants with lupus nephritis undergoing treatment with Euro-Lupus Nephritis low-dose cyclophosphamide. Serum IgG levels were assessed prior to initiation of treatment and throughout the trial. Hypogammaglobulinaemia was defined as IgG <450 mg/dL...
2017: Lupus Science & Medicine
https://www.readbyqxmd.com/read/29208014/plasma-c4d-as-marker-for-lupus-nephritis-in-systemic-lupus-erythematosus
#12
Myriam Martin, Karolina I Smoląg, Albin Björk, Birgitta Gullstrand, Marcin Okrój, Jonatan Leffler, Andreas Jönsen, Anders A Bengtsson, Anna M Blom
BACKGROUND: In the present study, we sought to evaluate the complement activation product C4d as a marker for lupus nephritis in systemic lupus erythematosus (SLE). METHODS: C4d levels were determined by enzyme-linked immunosorbent assay in plasma samples of patients with established SLE using a novel approach based on detection of a short linear cleavage neoepitope. Cross-sectional associations were studied in 98 patients with SLE with samples taken at lower or higher respective disease activity...
December 6, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29191575/-lupus-nephropathy-insight-in-new-treatments
#13
Virginie Jadot, Jean-Marie Krzesinski, Christian Von Frenckell, Christophe Bovy, Antoine Bouquegneau
Systemic lupus erythematosus is a chronic autoimmune disease. Both acquired and innate immune systems are involved in the development of this systemic disease. Lupus nephritis usually is the most serious manifestation of systemic lupus erythematosus, with significant morbidity and mortality. The physiopathological development of the renal involvement of lupus has been increasingly elucidated over the years and various target therapies have recently been developed. After some physiopathological reminders, we discuss the conventional treatment of lupus nephritis as well as the various therapeutic advances, in particular the contribution and the place of the new target therapies in the treatment of the lupus nephritis...
November 27, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29189089/interferon-inducible-mx1-protein-is-highly-expressed-in-renal-tissues-from-treatment-na%C3%A3-ve-lupus-nephritis-but-not-in-those-under-immunosuppressive-treatment
#14
Yuka Shimizu, Shinsuke Yasuda, Taichi Kimura, Saori Nishio, Michihiro Kono, Kazumasa Ohmura, Sanae Shimamura, Michihito Kono, Yuichiro Fujieda, Masaru Kato, Kenji Oku, Toshiyuki Bohgaki, Yuichiro Fukasawa, Shinya Tanaka, Tatsuya Atsumi
OBJECTIVES: The aim of this study was to clarify the consequences of Mx1, one of the IFN-inducible proteins, in the peripheral blood as well as in renal tissues in patients with systemic lupus erythematosus (SLE). PATIENTS AND METHODS: Mx1 protein concentrations in (PBMCs) from 18 SLE patients mostly in their stable disease status, 11 IgA nephropathy (IgAN) patients, 5 ANCA-associated vasculitis (AAV) patients and 16 healthy controls were measured using enzyme-linked immunosorbent assay (ELISA)...
November 30, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/29186654/treatment-with-allogenic-mesenchymal-stromal-cells-in-a-murine-model-of-systemic-lupus-erythematosus
#15
Chiara Tani, Sabrina Vagnani, Linda Carli, Francesca Querci, Anja A Kühl, Simone Spieckermann, Constanze Pamela Cieluch, Simone Pacini, Rita Fazzi, Marta Mosca
Objective: Pre-clinical and uncontrolled studies in patients with systemic lupus erythematosus (SLE) showed that mesenchymal stromal cells (MSCs) have a potential therapeutic role in refractory cases. The optimal therapeutic strategy in these patients remain to be elucidated. Our aim was to test the hypothesis that repeated administrations of 1×106/kg body weight of allogenic MSCs, that is a significantly lower dosage with respect to the fixed 1×106 MSC used in animal models, can be effective in improving the clinical course of a murine SLE model...
November 30, 2017: International Journal of Stem Cells
https://www.readbyqxmd.com/read/29186572/hydroxycloroquine-blood-concentration-in-lupus-nephritis-a-determinant-of-disease-outcome
#16
Cátia Cunha, Suceena Alexander, Damien Ashby, Janet Lee, Gary Chusney, Tom D Cairns, Liz Lightstone
Background: Hydroxychloroquine (HCQ) is a recommended drug in systemic lupus erythematosus (SLE). It has a long terminal half-life, making it an attractive target for therapeutic drug monitoring. The aim of this study was to establish a relationship between blood HCQ concentration and lupus nephritis activity. Methods: We conducted a retrospective observational study with data collected from clinical and laboratory records. Inclusion criteria were patients followed in the lupus clinic with biopsy-proven International Society of Nephrology/Renal Pathology Society Classes III, IV or V lupus nephritis on HCQ for at least 3 months (200-400 mg daily) and with HCQ levels measured during treatment...
November 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29181727/hospital-acquired-infection-in-patients-with-systemic-lupus-erythematosus-a-case-control-study-in-a-southern-chinese-population
#17
Zhongping Zhan, Minxi Lao, Fan Su, Dongying Chen, Liuqin Liang, Xiuyan Yang
The objective of this study is to investigate the current situation of hospital-acquired infection (HAI) in lupus patients from a southern Chinese population. A case-control study was performed. Data from Jan. 2007 to Jan. 2017 were collected. Each lupus patient with HAI was compared with two control individuals without infection selected from the same period of time. Three hundred and sixty episodes of HAI were analyzed. The average Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score at admission was 13...
November 27, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29180126/belimumab-in-the-treatment-of-systemic-lupus-erythematous-an-evidence-based-review-of-its-place-in-therapy
#18
REVIEW
Frederico Marcondes, Morton Scheinberg
INTRODUCTION: Systemic lupus erythematous is an autoimmune disease with diverse clinical features and has its development associated with a complexity of genetic, hormonal and environmental factors and the development of autoantibodies. Identification of new treatments is currently an area of intense investigation. Belimumab is the first biologic approved for the treatment of the disease inhibiting the excessive B cell activity observed in these patients and consequently reduction of autoantibodies...
November 24, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29173182/lupus-nephritis-current-treatment-paradigm-and-unmet-needs
#19
Steven P Menez, Basset El Essawy, Mohamed G Atta
BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by chronic inflammation, which can result in a multitude of systemic or organ-limited manifestations, including the skin, lungs, heart, and kidney. SLE nephritis is present in an average of 38% of patients at the time of diagnosis, and may occur as the initial presentation of disease with progression to end-stage renal disease (ESRD) in roughly 10-20% of patients. METHODS: A review of the current literature was undertaken to investigate the evolution of treatment of SLE nephritis based on randomized trials and robust observational studies...
November 22, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29130759/preeclampsia-in-pregnancies-complicated-by-sle-nephritis-prophylactic-treatment-with-multidisciplinary-approach-are-important-keys-to-prevent-adverse-obstetrics-outcomes
#20
Federico Mecacci, Serena Simeone, Calogero Lino Cirami, Mauro Cozzolino, Caterina Serena, Marianna Pina Rambaldi, Pamela Gallo, Lorenzo Emmi, Daniele Cammelli, Giorgio Mello, Marco Matucci Cerinic
INTRODUCTION: Systemic lupus erythematosus (SLE) commonly affects women of childbearing age. Hypertension, antiphospholipid syndrome and lupus nephritis are risk factors for adverse maternal/fetal outcome. The aim of this retrospective cohort study is to compare pregnancy outcomes in patients with and without SLE nephritis, using a multidisciplinary approach and a broad prophylaxis protocol. MATERIALS AND METHODS: Data were collected from 86 pregnancies complicated by SLE...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
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