Management of lupus nephritis: a systematic literature review informing the 2019 update of the joint EULAR and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations.

RMD Open
Myrto KostopoulouDimitrios T Boumpas

Abstract

To analyse the current evidence for the management of lupus nephritis (LN) informing the 2019 update of the EULAR/European Renal Association-European Dialysis and Transplant Association recommendations. According to the EULAR standardised operating procedures, a PubMed systematic literature review was performed, from January 1, 2012 to December 31, 2018. Since this was an update of the 2012 recommendations, the final level of evidence (LoE) and grading of recommendations considered the total body of evidence, including literature prior to 2012. We identified 387 relevant articles. High-quality randomised evidence supports the use of immunosuppressive treatment for class III and class IV LN (LoE 1a), and moderate-level evidence supports the use of immunosuppressive treatment for pure class V LN with nephrotic-range proteinuria (LoE 2b). Treatment should aim for at least 25% reduction in proteinuria at 3 months, 50% at 6 months and complete renal response (<500-700 mg/day) at 12 months (LoE 2a-2b). High-quality evidence supports the use of mycophenolate mofetil/mycophenolic acid (MMF/MPA) or low-dose intravenous cyclophosphamide (CY) as initial treatment of active class III/IV LN (LoE 1a). Combination of tacrolimus with MMF/MPA a...Continue Reading

References

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Jan 1, 2014·Canadian Journal of Kidney Health and Disease·Lauren GalbraithMichael Walsh

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Citations

Sep 1, 2020·AACN Advanced Critical Care·Erin K Gasser, Hildy M Schell-Chaple
Sep 6, 2020·Current Opinion in Rheumatology·Grainne Murphy, David A Isenberg
Sep 6, 2020·Current Opinion in Rheumatology·Guillermo Ruiz-IrastorzaAdriana Soto-Peleteiro
Sep 15, 2020·Current Opinion in Rheumatology·Martin Aringer, Michelle Petri
Jan 31, 2021·International Journal of Molecular Sciences·Carlos Rafael-VidalSamuel Garcia
Apr 4, 2021·Pharmaceuticals·Salvatore Di BartolomeoFrancesco Carubbi

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Methods Mentioned

BETA
biopsy
biopsies

Software Mentioned

Cochrane

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