Rethinking biologics in lupus nephritis

Venuturupalli, Swamy R.

doi:10.1177/0961203316652496

Cited by 7 publications

(5 citation statements)

References 52 publications

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“…Increased use of biologics in the Arabian Gulf region may be beneficial for patient outcomes; for example, rituximab and belimumab have been shown to improve renal outcomes in patients with LN. 87,88 Additionally, more specific treatment guidelines are needed for patients with LN from the Arabian Gulf region. Currently, centres within this region follow a mixture of the APLAR, EULAR or KDIGO guidelines for treating patients with LN.…”

Section: Discussionmentioning

confidence: 99%

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Literature review of lupus nephritis From the Arabian Gulf region

Al-Shujairi

Elbadawi

Al-Saleh

et al. 2022

Lupus

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Introduction The severity of lupus nephritis (LN) varies between different ethnicities. However, there are limited data regarding disease severity for LN in patients from the Arabian Gulf region; moreover, there are no treatment guidelines developed specifically for this population. The objective of this review was to characterise the incidence of LN, current treatment practices, the severity of LN, and the pathophysiology and biomarkers associated with LN in the Arabian Gulf region. Methods A literature search using EMBASE was conducted in October, 2021 to identify publications reporting on the incidence, treatment practices, severity, pathophysiology or biomarkers associated with LN, from countries in the Arabian Gulf region (including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates). Additional relevant publications were provided by collaborators. A manual review of the publications was conducted to determine their relevance and data on the outcomes of interest were extracted. Results Of 3705 publications, 54 publications were identified as relevant. LN is one of the most commonly diagnosed renal diseases within the Arabian Gulf and approximately 10%–36% of all renal biopsies are for LN. Treatment patterns within the region appear to vary and generally follow treatment guidelines recommended by the Asia Pacific League of Associations for Rheumatology (APLAR), the European Alliance of Associations for Rheumatology (EULAR) and Kidney Disease Improving Global Outcomes (KDIGO). The majority of patients receive cyclophosphamide for induction therapy, whilst others receive mycophenolate mofetil. Most studies showed that the most frequently diagnosed class of LN within the Arabian Gulf region was Class IV (up to 63% of patients with LN). Sustained or increased levels of serum creatinine and proteinuria; and depressed levels of complement C3/C4 were commonly seen among patients with LN from the Arabian Gulf region. Conclusions This review identified that LN may manifest more severely among patients from the Arabian Gulf region than in other populations, such as Caucasian populations. A greater understanding of LN and the treatment practices within the region, as well as the development of more specific treatment guidelines for this population may help improve outcomes for patients with LN in the Arabian Gulf region.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Literature review of lupus nephritis From the Arabian Gulf region

Al-Shujairi

Elbadawi

Al-Saleh

et al. 2022

Lupus

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“…Although numerous clinical trials of biologics have yielded disappointing results for LN, novel agents continue to emerge, and there is optimism that some will be proven effective (31). Koutsokeras and Healy (32,33) forecasted the LN market to be $505 million by 2022 for seven major international markets (United States, France, Germany, Italy, Spain, the United Kingdom, and Japan).…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the frequency and survival of SLE-related ESRD has not improved over several decades (7,8,29,30), highlighting the need for new therapies. Although numerous clinical trials of biologics have yielded disappointing results for LN, novel agents continue to emerge, and there is optimism that some will be proven effective (31). Koutsokeras and Healy (32,33) forecasted the LN market to be $505 million by 2022 for 7 major international markets (US, France, Germany, Italy, Spain, the UK, and Japan).…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluation of Lupus Nephritis in the Systemic Lupus International Collaborating Clinics Inception Cohort Using a Multistate Model Approach

Barber

Hanly

et al. 2018

Arthritis Care & Research

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“…Current therapeutic approaches cannot meet the clinical demands of patients who have lupus nephritis and are limited by suboptimal efficacy of the treatment and increased risk of infections. Several novel biologic agents for lupus nephritis also show substantial toxicity, and the results of long-term application remain unknown [9][10][11]. Given the complexity, cost and apparent ineffectiveness of the therapeutic armamentarium used in lupus nephritis, complementary and integrative therapies are becoming increasingly attractive [12,13].…”

Section: Introductionmentioning

confidence: 99%

Traditional Chinese Herbal Medicine and Lupus Nephritis

Mu¹,

Jiang²,

Wang³

2018

Health Care Current Reviews

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Available treatments for lupus nephritis, a potentially fatal autoimmune disease, are limited by suboptimal efficacy and increased risk of infections and malignancies; inevitably they do not meet clinical demands. Traditional Chinese herbal medicine has recently been recognized for its potential therapeutic benefits for lupus nephritis. Encouraging evidence from clinical trials and observational studies demonstrate that Chinese herbal medicine may possess benefits for treating patients with lupus nephritis. The significant benefits of these Chinese herbal medicine modalities that have been observed and reported include improving clinical efficacy, reducing level of antibodies and proteinuria, ameliorating renal damage, diminishing the dosage of prednisone use as well as decreasing toxicity, and preventing disease flare-up. This overview aggregates the current body of medical knowledge on the therapeutic benefits of several types of Chinese herbal medicines for lupus nephritis, and these promising herbal medicines may challenge the current treatment paradigms available for lupus nephritis and inform future research and clinical practice.

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Rethinking biologics in lupus nephritis

Cited by 7 publications

References 52 publications

Literature review of lupus nephritis From the Arabian Gulf region

Literature review of lupus nephritis From the Arabian Gulf region

Economic Evaluation of Lupus Nephritis in the Systemic Lupus International Collaborating Clinics Inception Cohort Using a Multistate Model Approach

Traditional Chinese Herbal Medicine and Lupus Nephritis

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