Prospects for the use of Belimumab in lupus nephritis

Over the past 50 years the survival rate of patients with systemic lupus erythematosus (SLE) significantly improved, however, it is necessary to develop a new generation of drugs for the treatment of lupus nephritis (LN), the development of which is one of the main factors of high mortality risk in at least 50% of SLE patients. The international clinical trial BLISS-LN has demonstrated a high rate of achievement and maintenance of renal response (RR), confirmed by a higher rate of achievement of RR primary efficacy and complete renal response when using belimumab (BLM) in addition to standard therapy (ST) compared to ST alone in patients with LN. When using BLM, there was a statistically significant reduction in the risk of developing adverse renal events (in particular, deterioration of renal function) or death within 104 weeks compared with placebo. Improvement in LN outcomes was achieved in the setting of long-term reduction in glucocorticoids use after the induction phase. With BLM therapy, there was also a decrease in the total activity of SLE, a decrease in the number of severe exacerbations, and an improvement in serological markers. The benefit/risk ratio of BLM in combination with ST for LN treatment was favorable. BLM can be recommended for LN therapy in combination with standard treatment methods in order to achieve and maintain remission. © 2021, Ima-Press Publishing House. All rights reserved

The 2019 updated EULAR/ERA-EDTA guidelines for the management of lupus nephritis. Expert comments. Part I

The paper presents the main provisions of the 2019 updated European League Against Rheumatism (EULAR)/European Renal Association (ERA) - European Dialysis and Transplant Association (EDTA) guidelines for the management of lupus nephritis. It discusses the technology of preparing recommendations by an international group of rheumatologists, nephrologists, morphologists, and pediatricians. The main part contains recommendations on the use of induction and maintenance therapy with immunosuppressants, glucocorticoids, and biological agents. The issues relating to the management of pregnant patients with end-stage renal failure are considered. © 2020, Ima-Press Publishing House. All rights reserved

The 2019 updated eular/era-edta guidelines for the management of lupus nephritis. Expert comments. part ii

The paper presents the main provisions of the updated 2019 EULAR/ERA-EDTA guidelines for the lupus nephritis (LN) therapy, which have been prepared by an international group of rheumatologists, nephrologists, morphologists, and pediatricians. Part 2 of the article discusses additional therapy, monitoring, and prognosis for LN, and the management of patients with end-stage renal failure and antiphospholipid syndrome. Attention is paid to the problem of LN and pregnancy, as well as to the management of pediatric patients with kidney damage. © 2021, Ima-Press Publishing House. All rights reserved