B-cell depletion or belimumab or voclosporin for lupus nephritis?
| Autor: | Hans-Joachim Anders, Yutian Lei, Jerome Loutan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Cyclophosphamide 030232 urology & nephrology Lupus nephritis 030204 cardiovascular system & hematology Antibodies Monoclonal Humanized Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine AURORA trial Obinutuzumab Internal medicine Internal Medicine medicine Humans B-Lymphocytes business.industry medicine.disease Belimumab Lupus Nephritis Voclosporin Calcineurin Clinical trial Treatment Outcome chemistry Nephrology Cyclosporine business Immunosuppressive Agents medicine.drug |
| Zdroj: | Current opinion in nephrology and hypertension. 30(2) |
| ISSN: | 1473-6543 |
| Popis: | Purpose of review Despite ground-breaking innovations for most autoimmune diseases, the treatment of lupus nephritis has remained largely the same for decades because none of the tested drugs demonstrated superiority over standard-of-care in randomized controlled clinical trials. Recent findings Recently, the Belimumab in Subjects with Systemic Lupus Erythematosus - Lupus Nephritis trial tested belimumab, an inhibitor of B-cell activating factor, as an add-on therapy to steroids and either mycophenolate mofetil (MMF) or cyclophosphamide when given IV monthly over a period of 104 weeks at an effect size of 11% for a Primary Efficacy Renal Response. The NOBILITY trial reported positive results for the B-cell-depleting agent obinutuzumab as an add-on therapy to steroids and MMF when given IV every 6 months over a period of 76 weeks at an effect size of 22% for a complete renal response (CRR). The AURORA trial reported positive results for the calcineurin inhibitor voclosporin as an oral add-on therapy to low dose steroids and MMF when given twice daily over a period of 52 weeks at an effect size of 18.5% for a CRR. Summary These studies will change the treatment landscape of lupus nephritis. In which way is discussed in this article. |
| Databáze: | OpenAIRE |
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