I suspect that the manuscript for this excellent article by my esteemed colleagues, Dr. Siegel and Sammaritano, was written before the latest EULAR recommendations were published.
I cringed when I read on this outline (and I'd love for it to be removed) that the "SOC for LN treatment" was stated as such. Many, to most of us, would use "combination therapy" for proliferative LN (meaning CYC or MMF + belimumab and/or a calcineurin inhibitor + IV pulse steroids at lower doses than in the past followed by lower doses of oral steroids than in the past).
Reason being: the vast majority of our patients with LN do not achieve a complete renal response and are at high risk for ESRD. Once nephrons are lost: it is permanent. Combination therapy, using BEL or a CNI, immediately increases CRRs, reduces steroids, and reduces long-term renal complications.
Please consider revising this list. I'd hate to see non-lupologists reading this and thinking this statement is still the standard of care. This is a great example of how medical information changes incredibly quickly, and this statement is now outdated.
If I had LN, I'd demand BEL +/or CNI and less steroids immediately for treatment.
I suspect that the manuscript for this excellent article by my esteemed colleagues, Dr. Siegel and Sammaritano, was written before the latest EULAR recommendations were published.
I cringed when I read on this outline (and I'd love for it to be removed) that the "SOC for LN treatment" was stated as such. Many, to most of us, would use "combination therapy" for proliferative LN (meaning CYC or MMF + belimumab and/or a calcineurin inhibitor + IV pulse steroids at lower doses than in the past followed by lower doses of oral steroids than in the past).
Reason being: the vast majority of our patients with LN do not achieve a complete renal response and are at high risk for ESRD. Once nephrons are lost: it is permanent. Combination therapy, using BEL or a CNI, immediately increases CRRs, reduces steroids, and reduces long-term renal complications.
Please consider revising this list. I'd hate to see non-lupologists reading this and thinking this statement is still the standard of care. This is a great example of how medical information changes incredibly quickly, and this statement is now outdated.
If I had LN, I'd demand BEL +/or CNI and less steroids immediately for treatment.