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Lupus Nephritis

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39 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Desmond Yh Yap, Susan Yung, Tak Mao Chan
Immunosuppressive therapies for lupus nephritis (LN) have improved significantly over the past few decades, resulting in growing number of choices for treatment individualization and improved renal and patient outcomes. Corticosteroids combined with mycophenolate or cyclophosphamide induces a satisfactory response in a high proportion of Asian and Caucasian patients, but the rate of improvement varies considerably between patients. Relatively low disease flare rate was observed in Chinese patients receiving low-dose prednisolone and mycophenolate maintenance...
October 2018: Nephrology
Ronald F van Vollenhoven, Bevra H Hahn, George C Tsokos, Carrie L Wagner, Peter Lipsky, Zahi Touma, Victoria P Werth, Robert M Gordon, Bei Zhou, Benjamin Hsu, Marc Chevrier, Manon Triebel, Jarrat L Jordan, Shawn Rose
BACKGROUND: Ustekinumab is a monoclonal antibody targeting interleukin (IL)-12 and IL-23 and is approved for the treatment of plaque psoriasis, psoriatic arthritis, and Crohn's disease. IL-12 and IL-23 have been implicated in systemic lupus erythematosus. We aimed to assess the efficacy and safety of ustekinumab for the treatment of systemic lupus erythematosus in patients with moderate-to-severe disease activity despite conventional treatment. METHODS: This was a multicentre, double-blind, phase 2, randomised, controlled trial of adult patients with active, seropositive systemic lupus erythematosus, done at 44 private practices and academic centres in Argentina, Australia, Germany, Hungary, Mexico, Poland, Spain, Taiwan, and the USA...
October 13, 2018: Lancet
Nathalie Costedoat-Chalumeau, Frédéric A Houssiau
No abstract text is available yet for this article.
October 13, 2018: Lancet
Patrick H Nachman
There is scant controlled data to guide the use of repeat kidney biopsies to guide therapy in glomerular disease. De Rosa et al. assessed the value of a repeat biopsy during remission in estimating the risk of subsequent relapse of lupus nephritis. They demonstrated the feasibility of a per-protocol repeat biopsy study with prespecified subsequent therapy. Their results will inform the design of future studies of repeat biopsies in lupus nephritis and other kidney diseases.
October 2018: Kidney International
Meggan Mackay, Maria Dall'Era, Joanna Fishbein, Kenneth Kalunian, Martin Lesser, Jorge Sanchez Guerrero, Deborah M Levy, Earl Silverman, Michelle Petri, Cristina Arriens, Edmund J Lewis, Stephen M Korbet, Fabrizio Conti, Vladimir Tesar, Zdenka Hruskova, Eduardo F Borba, Eloisa Bonfa, Tak Mao Chan, Manish Rathi, K L Gupta, Vivekanand Jha, Sarfaraz Hasni, Melissa R West, Elian Silverman, Neil Solomons, Frederic A Houssiau, Juanita Romera Diaz, Juan Mejia-Vilet, Brad H Rovin
OBJECTIVE: Endpoints currently used in lupus nephritis (LN) clinical trials lack uniformity and questionably reflect long-term kidney survival. The objective of this investigation was to identify short-term endpoints that predict long-term kidney outcomes for use in clinical trials. METHODS: A database of 944 LN patients was assembled from 3 clinical trials and 12 longitudinal cohorts. Variables from the first 12 months of treatment after diagnosis of active LN (prediction period) were assessed as potential predictors of long-term outcomes in a 36 month follow-up period...
September 17, 2018: Arthritis & Rheumatology
Desmond Y H Yap, Chun Hay Tam, Susan Yung, Sunny Wong, Colin S O Tang, Temy M Y Mok, Catherine K Y Yuen, Maggie K M Ma, Chak Sing Lau, Tak Mao Chan
Background: There is little data on mycophenolic acid (MPA) pharmacokinetics and pharmacogenomics and optimal MPA exposure in lupus nephritis (LN) patients during long-term maintenance. Methods: We measured blood MPA levels at 1, 2, 4, 8, 10 and 12-h post-dose (i.e. C1, C2, C4, C8, C10 and C12) in 88 stable LN patients receiving maintenance prednisolone and mycophenolate mofetil, repeated every 6 months. The relationship between MPA exposure and single nucleotide polymorphisms (SNPs) of adenosine triphosphate-binding cassette subfamily C member 2 (ABCC2; rs2273697, rs3740066, rs717620 and rs17222723), organic anion-transporting polypeptides (OATPs; rs7311358 and rs4149117) and uridine diphosphate glucuronosyltransferase (UGT; rs17863762, rs6714486, rs17868320 and rs72551330) was also investigated...
September 11, 2018: Nephrology, Dialysis, Transplantation
Salem Almaani, Brad H Rovin
Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease that commonly affects the kidneys. It is characterized by persistent autoantibody production that targets a multitude of self-antigens. B-cells, plasmablasts and plasma cells, as the source of these autoantibodies, play a major role in the development of lupus nephritis (LN), and are therefore promising therapeutic targets. To date, however, randomized clinical trials of B-cell therapies in LN have not lived up to expectations, whereas uncontrolled cohort and observational studies of B-cell antagonists have been more promising...
August 27, 2018: Nephrology, Dialysis, Transplantation
Hermine I Brunner, Gaurav Gulati, Marisa S Klein-Gitelman, Kelly A Rouster-Stevens, Lori Tucker, Stacey P Ardoin, Karen B Onel, Rylie Mainville, Jessica Turnier, Pinar Ozge Avar Aydin, David Witte, Bin Huang, Michael R Bennett, Prasad Devarajan
OBJECTIVES: To delineate urine biomarkers that reflect kidney structural damage and predict renal functional decline in pediatric lupus nephritis (LN). METHODS: In this prospective study, we evaluated kidney biopsies and urine samples of 89 patients with pediatric LN. Urinary levels of 10 biomarkers [adiponectin, ceruloplasmin, kidney injury molecule-1, monocyte chemotactic protein-1, neutrophil gelatinase-associated lipocalin, osteopontin, transforming growth factor-ß (TGFß), vitamin-D binding protein, liver fatty acid binding protein (LFABP), and transferrin] were measured...
August 29, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Cristina Pamfil, Zuzanna Makowska, Aurélie De Groof, Gaëlle Tilman, Sepideh Babaei, Christine Galant, Pauline Montigny, Nathalie Demoulin, Michel Jadoul, Selda Aydin, Ralf Lesche, Fiona McDonald, Frédéric A Houssiau, Bernard R Lauwerys
OBJECTIVES: Chronic renal impairment remains a feared complication of lupus nephritis (LN). The present work aimed at identifying mechanisms and markers of disease severity in renal tissue samples from patients with LN. METHODS: We performed high-throughput transcriptomic studies (Illumina HumanHT-12 v4 Expression BeadChip) on archived kidney biopsies from 32 patients with LN and eight controls (pretransplant donors). Histological staging (glomerular and tubular scores) and immunohistochemistry experiments were performed on the same and on a replication set of 37 LN kidney biopsy samples...
July 31, 2018: Annals of the Rheumatic Diseases
L Mu, Y Hao, Y Fan, H Huang, X Yang, A Xie, X Zhang, L Ji, Y Geng, Z Zhang
Objectives To investigate the mortality and causes of death in Chinese patients with systemic lupus erythematosus. Methods We collected the clinical data of all consecutive adult systemic lupus erythematosus patients at the Rheumatology department of Peking University First Hospital between January 2007 and December 2015. The primary causes of death were identified, the standardized mortality ratio and years of life lost were calculated, and the survival and variables associated with mortality were determined by Kaplan-Meier and Cox regression analysis respectively...
September 2018: Lupus
Daniel J Wallace, Richard A Furie, Yoshiya Tanaka, Kenneth C Kalunian, Marta Mosca, Michelle A Petri, Thomas Dörner, Mario H Cardiel, Ian N Bruce, Elisa Gomez, Tara Carmack, Amy M DeLozier, Jonathan M Janes, Matthew D Linnik, Stephanie de Bono, Maria E Silk, Robert W Hoffman
BACKGROUND: Patients with systemic lupus erythematosus have substantial unmet medical need. Baricitinib is an oral selective Janus kinase (JAK)1 and JAK2 inhibitor that we hypothesised might have therapeutic benefit in patients with systemic lupus erythematosus. METHODS: In this double-blind, multicentre, randomised, placebo-controlled, 24-week phase 2 study, patients were recruited from 78 centres in 11 countries. Eligible patients were aged 18 years or older, had a diagnosis of systemic lupus erythematosus, and had active disease involving skin or joints...
July 21, 2018: Lancet
Y Ding, L-M Nie, Y Pang, W-J Wu, Y Tan, F Yu, M-H Zhao
Objective This study aimed to evaluate the clinical value of urinary biomarkers including kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and monocyte chemoattractant protein-1 (MCP-1) in lupus nephritis. Methods A total of 109 biopsy-proven lupus nephritis patients were included and 50 healthy individuals were used as normal controls. Urinary KIM-1, NGAL, and MCP-1 levels were measured by ELISA and their correlations with clinical and histological features were assessed...
October 2018: Lupus
David J Tunnicliffe, Suetonia C Palmer, Lorna Henderson, Philip Masson, Jonathan C Craig, Allison Tong, Davinder Singh-Grewal, Robert S Flanc, Matthew A Roberts, Angela C Webster, Giovanni Fm Strippoli
BACKGROUND: Cyclophosphamide, in combination with corticosteroids, has been first-line treatment for inducing disease remission for proliferative lupus nephritis, reducing death at five years from over 50% in the 1950s and 1960s to less than 10% in recent years. Several treatment strategies designed to improve remission rates and minimise toxicity have become available. Treatments, including mycophenolate mofetil (MMF) and calcineurin inhibitors, alone and in combination, may have equivalent or improved rates of remission, lower toxicity (less alopecia and ovarian failure) and uncertain effects on death, end-stage kidney disease (ESKD) and infection...
June 29, 2018: Cochrane Database of Systematic Reviews
Youzhou Tang, Weiru Zhang, Minfeng Zhu, Li Zheng, Lingli Xie, Zhijiang Yao, Hao Zhang, Dongsheng Cao, Ben Lu
Effective treatment of lupus nephritis and assessment of patient prognosis depend on accurate pathological classification and careful use of acute and chronic pathological indices. Renal biopsy can provide most reliable predicting power. However, clinicians still need auxiliary tools under certain circumstances. Comprehensive statistical analysis of clinical indices may be an effective support and supplementation for biopsy. In this study, 173 patients with lupus nephritis were classified based on histology and scored on acute and chronic indices...
July 6, 2018: Scientific Reports
Yanyun Wang, Ye Tao, Yi Liu, Yi Zhao, Chao Song, Bin Zhou, Tao Wang, Linbo Gao, Lin Zhang, Huaizhong Hu
The current methods of monitoring the activity of lupus nephritis (LN) may cause unnecessary hospital visits or delayed immunosuppressive therapy. We aimed to find a urinary biomarker that could be developed as a home-based test for monitoring the activity of LN.Urine samples were collected immediately before a renal biopsy from patients of suspected active LN, and also from patients with inactive LN, systemic lupus erythematous without LN or healthy controls. Biomarker search was conducted on a cytokine antibody array and confirmation was done by quantitative evaluation with enzyme-linked immunosorbent assay...
June 2018: Medicine (Baltimore)
Cristina M Lanata, Joanne Nititham, Kimberly E Taylor, Sharon A Chung, Dara G Torgerson, Michael F Seldin, Bernardo A Pons-Estel, Teresa Tusié-Luna, Betty P Tsao, Eric F Morand, Marta E Alarcón-Riquelme, Lindsey A Criswell
OBJECTIVE: African Americans, East Asians, and Hispanics with systemic lupus erythematous (SLE) are more likely to develop lupus nephritis (LN) than are SLE patients of European descent. The etiology of this difference is not clear, and this study was undertaken to investigate how genetic variants might explain this effect. METHODS: In this cross-sectional study, 1244 SLE patients from multiethnic case collections were genotyped for 817,810 single-nucleotide polymorphisms (SNPs) across the genome...
2018: PloS One
Jiayue Wu, Jinghang Ma, Wei-Hong Zhang, Wen Di
Background: Although it is well established that systemic lupus erythematosus (SLE) negatively affects pregnancy outcomes, there is insufficient evidence on the effect of lupus nephritis (LN) on antenatal management and pregnancy outcomes. We performed a systematic review and meta-analysis to determine the association of LN with management and pregnancy outcomes in SLE patients. Methods: Embase, Medline, Cochrane, and were carefully searched for relevant English and Chinese language studies...
2018: Therapeutics and Clinical Risk Management
Hong Wang, Yi-le Ren, Jun Chang, Luo Gu, Ling-Yun Sun
Objectives: This study aims to conduct a meta-analysis to clarify the epidemiologic characteristics of biopsy-proven lupus nephritis (BPLN), including those relating to its prevalence and prognosis. Patients and methods: A literature search for relevant studies was conducted in the electronic databases of PubMed, Google Scholar, Embase, and Cochrane trial register. The following search terms were used for original articles published between January 1982 and April 2016: "lupus nephritis" or systemic lupus erythematosus ('SLE') or 'systemic lupus erythematous' and "pathology" or 'epidemiology' or prevalence or incidence...
March 2018: Archives of Rheumatology
Alejandra Londoño Jimenez, Wenzhu B Mowrey, Chaim Putterman, Jill Buyon, Beatrice Goilav, Anna Broder
OBJECTIVE: To characterize and compare the factors associated with tubulointerstitial inflammation (TII) and tubulointerstitial scarring, defined as interstitial fibrosis and/or tubular atrophy (IF/TA), in patients with lupus nephritis (LN). METHODS: We identified SLE patients with a renal biopsy consistent with LN between 2005 and 2017. Clinical data was collected from the medical records. Multivariable logistic regression models were fitted to assess factors associated with TII and with IF/TA (moderate-to-severe vs...
May 31, 2018: Arthritis & Rheumatology
B Obrișcă, R Jurubiță, A Andronesi, B Sorohan, C Achim, R Bobeica, M Gherghiceanu, E Mandache, G Ismail
Introduction Lupus nephritis (LN) affects nearly 60% of patients with systemic lupus erythematosus and up to 30% of them will progress to end-stage renal disease (ESRD), despite receiving aggressive immunosuppressive therapy. The prognostic value of ISN/RPS classification is controversial. Therefore, we aimed to identify clinical and pathological predictors of outcome in LN patients independent of this classification. Material and methods Thirty-seven patients with LN who underwent percutaneous kidney biopsy between 1997 and 2016 were included in this study...
August 2018: Lupus
2018-05-17 06:08:38
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