Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Curr Opin Nephrol Hypertens. 2013 Mar;22(2):224-30. doi: 10.1097/MNH.0b013e32835d921c.
Lupus nephritis occurs in as many as half of patients presenting with systemic lupus erythematosus and is a major predictor of morbidity and mortality in this patient population. Prior to the last decade, the treatment of lupus nephritis was largely limited to corticosteroids, high-dose alkylating agents, and azathioprine, and this therapy was broadly prescribed regardless of patient demographics, clinical presentation, or prior toxicities.
Over the last decade, new immunomodulatory agents have emerged as effective induction and maintenance therapies in lupus nephritis. With these options, physicians are able to individualize the treatment regimens in an attempt to maximize clinical benefit and minimize adverse events. Moreover, the influence of patient demographics on disease severity and response to treatment has come to the forefront.
Here, we review the recent progress made in the therapy of lupus nephritis with a focus on the randomized controlled trials which have demonstrated the efficacy of these new treatment regimens.
狼疮肾炎在半数以上系统性红斑狼疮患者中发生，是该患者人群发病率和死亡率的主要预测因素。在过去十年之前，狼疮肾炎的治疗主要限于皮质类固醇、大剂量烷化剂和硫唑嘌呤，而且无论患者的人口统计学特征、临床表现或既往毒性如何，都广泛地开这些药物。
在过去十年中，新的免疫调节剂已成为狼疮肾炎有效诱导和维持治疗的药物。有了这些选择，医生就能够对治疗方案进行个体化，以最大限度地提高临床获益并降低不良事件的发生风险。此外，患者人口统计学特征对疾病严重程度和治疗反应的影响已成为研究重点。
本文重点综述了狼疮肾炎治疗方面的最新进展，这些进展主要来自于随机对照试验，这些试验证实了这些新治疗方案的疗效。
