“90% of repeat biopsy will lead to change in treatment. Get the 2nd biopsy” – Dr. A Fava #RNL2024 @rheumnow https://t.co/wLaZelSeFo

@andreafava: 57% of pts w/ lupus nephritis are asymptomatic Screen w/ proteinuria- but does NOT correlate w/ intrarenal disease - Cannot differentiate classes, lagging indicator, does not distinguish inflammation from damage 87% repeat Bx lead to change in Rx #RNL2024 @RheumNow https://t.co/de66VSKUG1

“50% of pts with lupus nephritis are asymptomatic . You have to have a degree of kidney damage before you have proteinuria. Proteinuria does not correlate with intrarenal activity.” – Dr. A Fava #RNL2024 @rheumnow https://t.co/9aHmLG6VjA

ICYMI @eular_org 2023 SLE Treatment guidelines https://t.co/BkGhwQtSor @rheumnow #RNL2024 https://t.co/troJ9D6AGm

Dr. Kahlenberg reviews the cycle of lupus. #RNL2024 @RheumNow @Kahlenberglab Genetic > environmental > immune system activation > immunocomplexes > clinical disease https://t.co/Q7T9QpbFlm

Don’t forget: complement activation by Abs form immune complexes resulting tissue destruction in different organs. - Dr. M Kahlenberg may use AVISE CTD to help determine if pts are in a flare @rheumnow #RNL2024 https://t.co/wdwtq1G3Sn

Clinical Pearl! Lupus flare mimics with Dr. Kahlenberg - FM - Stress - Infection - Lack of sleep - Iron deficiency - Vitamin D deficiency - Celiac or other concomitant inflammatory disease - thyroid issues @Kahlenberglab @RheumNow #RNL2024 https://t.co/4vEjmwTd3D

Type I IFNs are a unique lupus feature. - Increase class switching - Repress TREGs - Drive rash development - DCs and B cells are more active Look at the signature graph on the R hand side of the screen. Dr. Kahlenberg #RNL2024 @RheumNow @Kahlenberglab https://t.co/zmClt9h3FW

Pro tip from Dr. Kahlenberg with regard to B cell activation: Belimumab takes a long time to work because it doesn't deal with ab secreting cells, it just blocks making new ones. #RNL2024 @RheumNow @Kahlenberglab https://t.co/gFwPeEdGF6

Would a wholistic B cell therapy, such as CAR-T, be more effective in Lupus? We know B cell activation is important but belimumab may work better for short-lived B cells and RTX doesn't deplete most plasma cells. CAR-T, targeting CD19, depletes all B cells. More research is… https://t.co/mPzKIfUC8p https://t.co/cGnI3dggqZ

The EULAR 2023 lupus flare guidelines (broken down here by renal and non-renal involvement) as reviewed by Dr. Kahlenberg. Remember to talk to patients about diet, adherence to treatment, skin protection, infection risk, vaccinations, blood glucose control, etc. #RNL2024… https://t.co/jUb04AFiA4 https://t.co/lATaUO75DA

Protips: Plasmablasts are made after B cell activation, making dsDNAAb & NMDA Ab that bind complement forming IC’s. A drug targeting plasmablast may be a better target. Belimumab may work better for short-lived B cell problems. – Dr. M Kahlenberg @rheumnow #RNL2024 https://t.co/vj6sRn4f7c