A range of medications are available to help treat lupus nephritis (LN), each offering a specific role in managing the condition. In a recent study, researchers evaluated published research on LN, focusing on treatment trends. This literature review suggests treatment options for LN should be individualized based on unique patient characteristics, considering factors such as disease severity and previous treatment responses.
Researchers conducted a comprehensive review of 7,898 published studies since 1990 on LN treatment. Ultimately, 16 studies met the inclusion criteria (study participant age between 18-75, with a confirmed diagnosis of SLE and GFR greater than 30mL/min/1.73m2). From there, researchers evaluated 12 different drugs and compared their effectiveness. Some of the drugs reviewed included:
- Belimumab (Benlysta®) is a valuable option for managing LN, particularly for people with active disease. Belimumab is typically used as an add-on therapy and is particularly beneficial for people with high disease activity who have not responded well to conventional therapies.
- Mycophoenolate Mofetil (MMF) demonstrated improved renal outcomes, including stabilization of kidney function and a significant reduction in proteinuria, compared to the control group. MMF is often preferred for its favorable side effect profile and for use in combination with corticosteroids.
- Obinutuzumab (GAZYVA®) treatment led to significant improvement in renal response compared to the placebo. This drug’s efficacy was notable in reducing disease activity and improving kidney function but had adverse effects including infusion-related reactions and a heightened risk of infections. Additionally, obinutuzumab showed promise in treating proliferative LN.
- Rituximab (Rituxan) showed significant improvement in renal response rates over the placebo, with a number of people reaching clinical remission. Rituximab is effective for people who are refractory to conventional treatments and is often used as a second-line treatment or in combination with other immunosuppressants.
- Tacrolimus is generally well-tolerated and effective in managing disease and diminishing T-cell activation and proliferation, but as a marginally lower safety profile in comparison to MMF.
- Volclosporin (Lupkynis™) demonstrated significant improvement in renal response compared to the placebo and was also effective in reducing proteinuria and improving overall kidney function in three studies. Side effects from the drug include hypertension, gastrointestinal disturbances, and increased risk of infections. Findings suggest that voclosporin is a promising treatment option with substantial therapeutic advantage over the placebo, resulting in higher remission rates and more effective symptom management.
While traditional immunosuppressive therapies remain the cornerstone of treatment, new treatments are emerging as promising avenues for improving patient outcomes. Continued research and collaboration among healthcare professionals are essential to advance the management of this challenging condition and enhance the quality of life for people with LN. Learn more about lupus nephritis and medications used to treat lupus.
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