Lupus Nephritis (LN) is a severe manifestation of Systemic Lupus Erythematosus (SLE) with a significant prognostic impact. Over a prolonged course, an exhaustion of treatment alternatives may occur and further therapeutic options are needed. B cells play a pivotal role in disease pathogenesis and represent an attractive therapeutic target. Areas covered: This review provides an update regarding targeting B cells in LN. The rational for this approach, as well as currently available and future targets are discussed. Expert commentary: Despite its wide clinical use and the encouraging results from retrospective studies, a role of rituximab in LN has not been prospectively confirmed. Trial design methodologies as well as intrinsic limitations of this approach may be responsible and rituximab use is currently limited as a rescue treatment or in settings where a strong steroid sparing effect is warranted. Despite belimumab now being licensed for use in SLE, the evidence in LN is weak although prospective trials are on-going. The combination of different targeted approaches as well as a focus on new clinical end-points may be strategies to identify new therapeutic options.

Lupus nephritis and B-cell targeting therapy / M. Cassia, F. Alberici, M. Gallieni, D. Jayne. - In: EXPERT REVIEW OF CLINICAL IMMUNOLOGY. - ISSN 1744-666X. - 13:10(2017 Oct), pp. 951-962. [10.1080/1744666X.2017.1366855]

Lupus nephritis and B-cell targeting therapy

F. Alberici;M. Gallieni
Penultimo
;
2017-10

Abstract

Lupus Nephritis (LN) is a severe manifestation of Systemic Lupus Erythematosus (SLE) with a significant prognostic impact. Over a prolonged course, an exhaustion of treatment alternatives may occur and further therapeutic options are needed. B cells play a pivotal role in disease pathogenesis and represent an attractive therapeutic target. Areas covered: This review provides an update regarding targeting B cells in LN. The rational for this approach, as well as currently available and future targets are discussed. Expert commentary: Despite its wide clinical use and the encouraging results from retrospective studies, a role of rituximab in LN has not been prospectively confirmed. Trial design methodologies as well as intrinsic limitations of this approach may be responsible and rituximab use is currently limited as a rescue treatment or in settings where a strong steroid sparing effect is warranted. Despite belimumab now being licensed for use in SLE, the evidence in LN is weak although prospective trials are on-going. The combination of different targeted approaches as well as a focus on new clinical end-points may be strategies to identify new therapeutic options.
Auto-antibodies; B cell; belimumab; lupus; lymphocytes; nephritis; rituximab
Settore MED/14 - Nefrologia
11-ago-2017
Article (author)
File in questo prodotto:
File Dimensione Formato  
submission.pdf

embargo fino al 22/12/2018

Descrizione: Manoscritto completo - post-print
Tipologia: Post-print, accepted manuscript ecc. (versione accettata dall'editore)
Dimensione 1.1 MB
Formato Adobe PDF
1.1 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/521352
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 20
  • ???jsp.display-item.citation.isi??? 19
social impact