Lupus Nephritis

Glomerulonephritis associated with autoimmune disease SYSTEMIC LUPUS ERYTHEMATOSUS. Lupus nephritis is histologically classified into 6 classes: class I - normal glomeruli, class II - pure mesangial alterations, class III - focal segmental glomerulonephritis, class IV - diffuse glomerulonephritis, class V - diffuse membranous glomerulonephritis, and class VI - advanced sclerosing glomerulonephritis (The World Health Organization classification 1982).

Also Known As:

Networked: 3205 relevant articles (321 outcomes, 494 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Systemic Lupus Erythematosus (Libman-Sacks Disease)
2.	Proteinuria
3.	Vasculitis (Vasculitides)
4.	Glomerulonephritis
5.	Nephrotic Syndrome (Syndrome, Nephrotic)

Experts

1.	Anders, Hans-Joachim: 34 articles (12/2015 - 03/2004)
2.	Putterman, Chaim: 30 articles (09/2015 - 03/2002)
3.	Rekvig, Ole Petter: 22 articles (09/2015 - 01/2006)
4.	Chan, Tak Mao: 21 articles (11/2015 - 11/2005)
5.	Rovin, Brad H: 17 articles (05/2015 - 10/2006)
6.	Mohan, Chandra: 17 articles (11/2014 - 08/2002)
7.	Moroni, Gabriella: 16 articles (10/2015 - 11/2003)
8.	Petri, Michelle: 16 articles (09/2015 - 08/2004)
9.	Mok, Chi Chiu: 14 articles (01/2016 - 04/2002)
10.	Yung, Susan: 14 articles (11/2015 - 05/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Lupus Nephritis:

1.	Cyclophosphamide (Cytoxan)FDA LinkGeneric 04/01/2014 - "There is little evidence to support the common assumption that intravenous pulse cyclophosphamide is the best treatment for lupus nephritis. " 06/01/2011 - "Ever since the introduction of cyclophosphamide (CY), the management of lupus nephritis has dramatically changed, and its prognosis has greatly improved. " 08/01/1989 - "Bolus intravenous cyclophosphamide therapy (IVCY) has recently been the subject of considerable attention because it is occasionally very effective in the treatment of severe lupus nephritis. " 08/01/1989 - "[A case of lupus nephritis resistant to steroid pulse therapy markedly improved by bolus intravenous cyclophosphamide therapy]." 03/01/2005 - "This house believes that low-dose intravenous cyclophosphamide is superior to standard high-dose regimes for treatment of lupus nephritis."
2.	mycophenolate mofetil (Cellcept)FDA LinkGeneric 01/01/2012 - "Clinical trials revealed a high efficacy of mycophenolate mofetil (MMF)in inducing and maintaining remission in patients with class III-V-lupus nephritis. " 11/01/2005 - "Short-term to intermediate-term, randomized controlled trials have shown that mycophenolate mofetil is a good option for the induction and maintenance of remission in lupus nephritis patients. " 11/24/2005 - "Since anecdotal series and small, prospective, controlled trials suggest that mycophenolate mofetil may be effective for treating lupus nephritis, larger trials are desirable. " 07/01/2011 - "To determine the timing for safe reduction of mycophenolate mofetil (MMF) dose during remission-maintenance therapy of proliferative lupus nephritis. " 01/01/2008 - "The efficacy of mycophenolate mofetil in the treatment of patients with lupus nephritis has been recently established in several clinical trials. "
3.	rituximab (Mabthera)FDA Link 03/01/2012 - "Efficacy of rituximab in 164 patients with biopsy-proven lupus nephritis: pooled data from European cohorts." 08/01/2009 - "There were no statistically significant differences in the proportion of patients with complete depletion at weeks 4, 8, 24 and 48 between the two groups except at week 2. Rituximab monotherapy appears to be effective as induction therapy in lupus nephritis. " 01/01/2007 - "Rituximab has shown promise in patients with active proliferative lupus nephritis, which suggests that B-cell depletion may be successful. " 04/01/2013 - "Systematic reviews of open label studies, particularly in lupus patients refractory to conventional therapy, have suggested that rituximab can be an effective treatment for non-renal lupus and lupus nephritis. " 07/01/2006 - "Rituximab, an anti-CD20 monoclonal antibody, has been used in lupus nephritis and membranous idiopathic nephropathy and has proved effective in non-renal manifestations of type II mixed cryoglobulinaemia (MC) syndrome. "
4.	Tacrolimus (Prograf)FDA LinkGeneric 01/01/2010 - "Improvement of the U-prot/U-creat ratio was most prominent for patients who were in WHO class IV. Tacrolimus is safe and effective as maintenance therapy for patients with lupus nephritis, at least for 6 months. " 01/01/2009 - "The purpose of this study was to examine whether tacrolimus is effective and safe, and to determine the optimal dose of tacrolimus for maintenance treatment in patients with lupus nephritis (LN). " 05/01/2011 - "One randomized controlled trial (RCT) found that tacrolimus significantly improved lupus nephritis disease activity index (LNDAI) as compared with a placebo, but no difference was observed between these two groups in terms of treatment-related adverse events. " 01/01/2009 - "In patients on glucocorticoid therapy for lupus nephritis, addition of tacrolimus to basal therapy achieved significant improvement compared with placebo. " 10/01/2014 - "Tacrolimus is an effective treatment for lupus nephritis in pregnancy."
5.	Azathioprine (Imuran)FDA LinkGeneric 09/01/2000 - "Long-term efficacy of azathioprine treatment for proliferative lupus nephritis." 11/01/2013 - "All prospective trials met the endpoints and in one trial MPS was even superior to azathioprine for treatment of lupus nephritis (LN) which led to the recommendation of MPS for induction and maintenance in LN by EULAR and EDTRA as well as more recently by the ACR. " 08/01/2001 - "In this open study, we compared the renal outcome of two historical cohorts of patients with diffuse proliferative lupus nephritis (World Health Organization classes IVa and IVb) treated with either intravenous (IV) pulse CYC (group A; n = 22) or sequential oral CYC followed by azathioprine (AZA; group B; n = 21) and followed up prospectively. " 05/01/2014 - "Maintenance therapy of lupus nephritis with mycophenolate or azathioprine: systematic review and meta-analysis." 02/09/2012 - "Mycophenolate or azathioprine maintenance in lupus nephritis."
6.	SteroidsIBA 01/01/2001 - "Recent studies suggest that it may also be effective in the treatment of patients with lupus nephritis when used in conjunction with steroids. " 11/01/1980 - "Treatment with steroids and/or immunosuppressives is effective in lupus nephritis; in other diseases, the results are less certain." 01/01/2014 - "The Steroids In the Maintenance of remission of Proliferative Lupus nephritis (SIMPL) pilot trial." 12/13/1984 - "We conclude that immunosuppressive drugs and steroids together are more effective than steroids alone in treating lupus nephritis and that published trials have reached false negative conclusions because of small sample sizes." 05/06/2014 - "Treatment of childhood lupus nephritis using steroids is associated with poor outcome and excess side-effects. "
7.	Adrenal Cortex Hormones (Corticosteroids)IBA 02/01/2015 - "Even though, recent biotherapies have not yet proved their efficacy in the field of lupus nephritis, new protocols are expected, aiming higher remission rates and avoidance of high-dose corticosteroids regimens. " 01/01/1988 - "Corticosteroids form the mainstay of therapy for lupus nephritis, provided that they achieve a prompt clinical remission which can be sustained with alternate day therapy. " 06/01/2010 - "In this 24-week trial, MMF or IVC combined with corticosteroids demonstrated equal efficacy in inducing remission of proliferative lupus nephritis." 02/01/2016 - "The dose and duration of corticosteroids required for control of lupus nephritis and CNS lupus have never been tested in a randomized trial design, so current recommendations are based on observation and expert opinion. " 12/01/2003 - "To relieve disease flare of lupus nephritis, a prospective pilot study of oral MZR pulse therapy (a phase II trial) is conducted as an alternative therapy to dose up of corticosteroids. "
8.	MethylprednisoloneFDA LinkGeneric 04/01/1981 - "High-dose intravenous methylprednisolone therapy may lead to striking improvement in renal function in lupus nephritis, especially in the subset of patients with recent antecedent functional deterioration. " 01/01/1994 - "Long term efficacy of high-dose intravenous methylprednisolone pulses in active lupus nephritis. " 03/01/1989 - "Lupus nephritis: efficacy of monthly pulse therapy with intravenous methylprednisolone." 01/01/2015 - "Methylprednisolone (MP) is used widely in the clinical treatment of progressive glomerular diseases such as lupus nephritis. " 01/01/2010 - "Renal biopsy revealed class V lupus nephritis, and she was treated with intravenous steroid (1 g methylprednisolone per day) for 3 days. "
9.	Prednisone (Sone)FDA LinkGeneric 02/01/2004 - "A combination of prednisone and AZA is reasonably effective for the initial treatment of pure membranous lupus nephritis. " 01/01/2004 - "In conclusion, MMF/prednisone therapy was effective for our patients with proliferative lupus nephritis. " 07/01/2011 - "Prednisone monotherapy induced remission in a group of patients with membranous lupus nephritis." 02/01/2004 - "Consecutive patients with pure membranous lupus glomerulonephritis (World Health Organization [WHO] Va and Vb) from 4 regional hospitals were recruited for an open-label treatment trial consisting of prednisone and AZA. " 01/01/2004 - "This study examines the clinical and histopathological effects, and potential mechanisms, of combination MMF/prednisone therapy in diffuse proliferative lupus nephritis. "
10.	Cyclosporine (Ciclosporin)FDA LinkGeneric 01/01/2001 - "In contrast, treatment with cyclosporin A (CyA) resulted in a marked regression of these nodules within one month, together with a complete remission of both MRH and lupus nephritis. " 07/01/2010 - "Good outcomes with mycophenolate-cyclosporine-based induction protocol in children with severe proliferative lupus nephritis." 10/01/2001 - "Sustained remission in a case of lupus nephritis with cyclosporin therapy." 09/01/1993 - "As cyclosporine appeared to be effective in experimental models of lupus nephritis, some studies have been performed using this drug in patients with lupus nephritis. " 01/01/1999 - "Cyclosporine demonstrates some efficacy in treating proliferative lupus nephritis and, based on pilot study data, membranous lupus as well. "

Therapies and Procedures

1.	Plasma Exchange 01/01/2016 - "A randomised controlled trial comparing the efficacy of standard of care (SOC) combined with plasma exchange against SOC alone in patients with lupus nephritis revealed no difference in terms of renal outcome. " 01/01/2012 - "Haemolytic-uraemic syndrome during severe lupus nephritis: efficacy of plasma exchange." 10/01/1995 - "There is still controversy about the efficacy of plasma exchange in the treatment of severe lupus nephritis. " 06/01/2001 - "On the basis of currently available studies, plasma exchange used alone or as an adjunct to conventional immunosuppressive therapy offers no clear benefit over standard immunosuppression in patients with active lupus nephritis and therefore cannot be recommended. " 02/01/2003 - "Hydroxyethylstarch as a replacement fluid in therapeutic plasma exchange for lupus nephritis in a Jehovah's Witness."
2.	Plasmapheresis 10/01/1992 - "The Lupus Nephritis Collaborative Study Group published two papers, one of which concerned the lack of efficacy of plasmapheresis in treating severe lupus nephritis. " 01/01/1998 - "Plasmapheresis remains under study but has not shown additional benefit in treatment of severe lupus nephritis. " 09/01/1993 - "A controlled trial of plasmapheresis showed no benefit over standard regimens in lupus nephritis. " 09/01/1992 - "A total of 86 patients entered into the study of plasmapheresis in severe SLE GN by the Lupus Nephritis Collaborative Study Group, and long-term follow-up was available in 83. " 05/21/1992 - "A controlled trial of plasmapheresis therapy in severe lupus nephritis. "
3.	Transplants (Transplant) 01/01/2006 - "In lately years MMF, a immune suppressor used in transplant, seems to be effective in selected cases of Lupus Nephritis. " 09/01/2012 - "Studies have shown that the survival of patients with lupus nephritis (LN) who receive a transplant has results similar to those of nondiabetic control subjects. " 04/01/2012 - "This study was conducted to delineate the frequency of recurrent lupus nephritis in a Chinese kidney transplant cohort and to estimate its impact on long-term transplant outcomes. " 06/01/2009 - "More recently, there has been increasing involvement of renal teams in clinical trials, particularly for lupus nephritis and renal transplant modulation." 10/01/1991 - "No major double-blind studies of therapy for lupus nephritis were published; however, the course of lupus patients receiving dialysis or grafts was the subject of three interesting studies. "
4.	Kidney Transplantation 08/01/2010 - "Recurrent lupus nephritis after kidney transplantation: a surveillance biopsy study." 03/15/2003 - "Although recurrent lupus nephritis (RLN) after kidney transplantation is reported to be rare (1%-4%), recent studies suggest a higher incidence. " 07/01/2014 - "[Renal transplantation in patients with lupus nephritis]." 01/01/2014 - "De novo lupus nephritis (LN) is a rare complication in renal transplantation recipients. " 09/01/2013 - "Other progress has been made in our understanding of the pathogenesis of lupus nephritis, outcomes in renal transplantation, and associations with genetic risk factors. "
5.	Remission Induction 10/01/2009 - "Taken together, our data allow us to draw the conclusion that life expectancy in women with Lupus nephritis has improved over time, paralleling an improved awareness of the disease and a significant increase in steroid pulse therapy as induction/remission phase. " 05/01/2010 - "Despite several large clinical trials in lupus nephritis, no second line drug is licensed for use in induction of remission in lupus nephritis. " 08/01/2014 - "Identification of stage-specific genes associated with lupus nephritis and response to remission induction in (NZB × NZW)F1 and NZM2410 mice." 11/01/2013 - "We therefore concluded that this first use in China as remission induction therapy in lupus nephritis patients of MZR, which is recognized as an effective maintenance therapy in Japan, was effective. " 01/01/2010 - "Lupus nephritis is a challenging clinical condition for which current therapies are unsatisfactory with respect to both remission induction and unwanted toxic effects. "