Meliambro Kristin, Campbell Kirk N, Chung Miriam
Division of Nephrology, Icahn School of Medicine at Mount Sinai, Box 1243, One Gustave L. Levy Place, New York, NY 10029, USA.
Division of Nephrology, Icahn School of Medicine at Mount Sinai, Box 1243, One Gustave L. Levy Place, New York, NY 10029, USA.
Rheum Dis Clin North Am. 2018 Nov;44(4):545-560. doi: 10.1016/j.rdc.2018.06.002. Epub 2018 Sep 7.
Proliferative lupus nephritis requires prompt diagnosis and treatment with immunosuppressive therapy. Cyclophosphamide is the longest studied agent, but mycophenolate mofetil has recently emerged as an efficacious induction and maintenance treatment that does not impart the risk of infertility. However, overall remission rates remain suboptimal and there is a need for improved therapeutic options. To this end, ongoing clinical studies are focusing on agents that target key molecules and pathways implicated in the pathogenesis of lupus nephritis based on previous animal and human studies. This article reviews key findings of trials supporting established induction and maintenance treatment regimens along with novel therapeutic investigations.
增殖性狼疮性肾炎需要通过免疫抑制疗法进行及时诊断和治疗。环磷酰胺是研究时间最长的药物,但霉酚酸酯最近已成为一种有效的诱导和维持治疗药物,且不会带来不孕风险。然而,总体缓解率仍不尽人意,因此需要改进治疗方案。为此,基于之前的动物和人体研究,正在进行的临床研究聚焦于针对狼疮性肾炎发病机制中关键分子和途径的药物。本文回顾了支持既定诱导和维持治疗方案的试验关键发现以及新的治疗研究。