Research and Reports in Urology (Jul 2023)
Promising Experimental Treatments for Lupus Nephritis: Key Talking Points and Potential Opportunities
Abstract
Ana Neves,1 Luísa Viveiros,2 Veronica Venturelli,3 David A Isenberg4 1Internal Medicine Department, Centro Hospitalar Universitário de São João, Oporto, Portugal; 2Internal Medicine Department, Centro Hospitalar Universitário de Santo António, Oporto, Portugal; 3Rheumatology Unit, Department of Medical Sciences, Università degli Studi di Ferrara, Azienda Ospedaliero-Universitaria S. Anna, Cona, Italy; 4Centre for Rheumatology, Department of Medicine, University College London, London, UKCorrespondence: David A Isenberg, The Department of Rheumatology, Division of Medicine, University College London, Room 423 the Rayne Building, London, WC1E 6JF, UK, Email [email protected]: Lupus nephritis (LN) is a frequent and serious complication of systemic lupus erythematosus (SLE), impairing patients’ quality of life and significantly increasing mortality. Despite optimizing the use of conventional immunosuppressants and other biological drugs, its management remains unsatisfactory. This is mainly due to the heterogeneity of SLE, but also to insufficiently effective treatment regimens and clinical trial limitations (strict criteria, low number of patients included, and side effects). Most clinical trials of new biological therapies have failed to meet their primary endpoints in both general SLE and LN, with only two biological drugs (belimumab and anifrolumab) being approved by the Food and Drug Administration (FDA) for the treatment of SLE. Recently, several Phase II randomized controlled trials have evaluated the efficacy and safety of new biologics in LN, and some of them have demonstrated an improvement in clinical and laboratory measures. Multi-target therapies are also being successfully developed and encourage a belief that there will be an improvement in LN outcomes.Keywords: biological therapies, systemic lupus erythematosus, lupus nephritis, trial
