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Lupus Nephritis

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47 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Veronica G Anania, Kebing Yu, Francesco Pingitore, Qingling Li, Christopher M Rose, Peter Liu, Wendy Sandoval, Ann E Herman, Jennie R Lill, W Rodney Mathews
Lupus nephritis (LN) is a severe clinical manifestation of systemic lupus erythematosus (SLE) associated with significant morbidity and mortality. Assessment of severity and activity of renal involvement in SLE requires a kidney biopsy, an invasive procedure with limited prognostic value. Non-invasive biomarkers are needed to inform treatment decisions and to monitor disease activity. Proteinuria is associated with disease progression in LN, however, the composition of the LN urinary proteome remains incompletely characterized...
December 10, 2018: Journal of Proteome Research
Yuan An, Yunshan Zhou, Liqi Bi, Bo Liu, Hong Wang, Jin Lin, Danyi Xu, Mei Wang, Jing Zhang, Yongfu Wang, Yan An, Ping Zhu, Ronghua Xie, Zhiyi Zhang, Yifang Mei, Xiangyuan Liu, Xiaoli Deng, Zhongqiang Yao, Zhuoli Zhang, Yu Wang, Weiguo Xiao, Hui Shen, Xiuyan Yang, Hanshi Xu, Feng Yu, Guochun Wang, Xin Lu, Yang Li, Yingnan Li, Xiaoxia Zuo, Yisha Li, Yi Liu, Yi Zhao, Jianping Guo, Lingyun Sun, Minghui Zhao, Zhanguo Li
OBJECTIVES: The standard strategy for treating lupus nephritis comprises glucocorticoids together with either intravenous cyclophosphamide or oral mycophenolate mofetil, but the low remission rate is still a challenge in practice. This study was aimed to seek higher remission rate of lupus nephritis using a combined strategy. METHOD: A 24-week trial was conducted in 17 rheumatology or nephrology centers in China. A total of 191 lupus nephritis patients were randomized to follow a combined immunosuppressive treatment (CIST) with intravenous cyclophosphamide, an oral immunosuppressive agent, namely mycophenolate mofetil, azathioprine or leflunomide, and hydroxychloroquine (n = 95), or receive intravenous cyclophosphamide alone (n = 96) for 24 weeks...
November 28, 2018: Clinical Rheumatology
Maria Infantino, Mariangela Manfredi, Paolo Soda, Mario Merone, Antonella Afeltra, Amelia Rigon
No abstract text is available yet for this article.
November 17, 2018: Annals of the Rheumatic Diseases
M Castro, M Ugolini-Lopes, E F Borba, E Bonfá, L P C Seguro
OBJECTIVE: The objective of this study is to evaluate the efficacy of a tightly controlled renoprotective protocol in systemic lupus erythematosus (SLE) patients with persistent proteinuria. METHODS: Thirteen SLE patients with nephritis and persistent proteinuria (>1 g/24 hours) were included. The protocol consisted of regular clinical evaluations every two weeks to assess blood pressure (BP, target <130/80 mmHg), adherence to therapy, diet and smoking...
December 2018: Lupus
L Pacheco-Lugo, J Sáenz-García, E Navarro Quiroz, H González Torres, L Fang, Y Díaz-Olmos, G Garavito de Egea, E Egea Bermejo, G Aroca Martínez
BACKGROUND: Systemic lupus erythematosus is a heterogeneous chronic inflammatory autoimmune disorder characterized by an exacerbated expression of cytokines and chemokines in different tissues and organs. Renal involvement is a significant contributor to the morbidity and mortality of systemic lupus erythematosus, and its diagnosis is based on renal biopsy, an invasive procedure with a high risk of complications. Therefore, the development of alternative, non-invasive diagnostic tests for kidney disease in patients with systemic lupus erythematosus is a priority...
November 19, 2018: Lupus
Brad H Rovin, Neil Solomons, William F Pendergraft, Mary Anne Dooley, James Tumlin, Juanita Romero-Diaz, Lidia Lysenko, Sandra V Navarra, Robert B Huizinga
Calcineurin inhibitors added to standard-of-care induction therapy for lupus nephritis (LN) may increase complete renal remission (CRR) rates. The AURA-LV study tested the novel calcineurin inhibitor voclosporin for efficacy and safety in active LN. AURA-LV was a Phase 2, multicenter, randomized, double-blind, placebo-controlled trial of two doses of voclosporin (23.7 mg or 39.5 mg, each twice daily) versus placebo in combination with mycophenolate mofetil (2 g/d) and rapidly tapered low-dose oral corticosteroids for induction of remission in LN...
November 5, 2018: Kidney International
H Hanaoka, H Iida, T Kiyokawa, Y Takakuwa, K Kawahata
We determined the clinical utility of the direct Coombs' test in the absence of hemolytic anemia as an indicator of disease activity and therapeutic response in systemic lupus erythematosus (SLE). SLE patients without hemolytic anemia who visited our hospital from January 2016 to November 2016 were retrospectively evaluated with a direct Coombs' test. Clinical features, including SLE disease activity index (SLEDAI), treatment and laboratory findings were analyzed. For patients with lupus nephritis, we additionally evaluated the cumulative complete renal response rate over one year after induction therapy...
December 2018: Lupus
David J Tunnicliffe, Suetonia C Palmer
No abstract text is available yet for this article.
November 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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...
January 2019: 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...
December 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
2018-07-20 10:16:15
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