Timely diagnosis and effective treatment are critical to outcomes for childhood-onset systemic lupus erythematosus (SLE). Further, nephritis is a common organ involvement observed in patients with the disease and is associated with significant morbidity and mortality.
The Sunday, Nov. 12, session Under Pressure: Updates in Lupus Nephritis will address the potential of histology and biomarkers as prognostic markers and examine anti-hypertensive and other non-immunological treatments.
The session will begin at 9 a.m. PT in Room 6A-B of the San Diego Convention Center. It will be livestreamed and will be available on demand within 24 hours of the live presentation for registered ACR Convergence 2023 participants.
“Lupus nephritis is one of the most severe complications of SLE leading to poor outcomes,” said pediatric nephrologist Mark Mitsnefes, MD, MS, Professor in the Department of Pediatrics and Director of the Clinical and Translational Research Center, Cincinnati Children’s Hospital Medical Center. “While immune therapy is a cornerstone of management in patients with lupus nephritis, non-immune therapy to control proteinuria — a major marker of progression of chronic kidney disease (CKD) — is very important to delay progression of CKD.”
Dr. Mitsnefes will present new data from clinical trials using sodium-glucose cotransporter-2 (SGLT2) inhibitors and non-steroidal mineralocorticoid antagonists and discuss non-immunological therapies for controlling proteinuria in patients with lupus nephritis. Current therapies include angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).
“However, over the last few years, large clinical trials using novel therapies showed additive effect to ACEI or ARBs on controlling proteinuria and delaying progression of CKD,” Dr. Mitsnefes explained.
He also will discuss ongoing clinical trials in children with CKD to control proteinuria.
The session speakers will illustrate that treatment of lupus nephritis should not only focus on renal remission, but also aim at controlling hypertension, preventing organ damage, and minimizing comorbidities and drug toxicity.
Simone Appenzeller, MD, PhD, Professor of Rheumatology, School of Medical Science, University of Campinas, Brazil, will provide an overview of the relevance of histology on pediatric lupus nephritis prognosis.
Hermine Brunner, MD, MSc, MBA, Professor in the Department of Pediatrics and Director of the Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, will discuss diagnostic and prognostic biomarkers of the disease. While renal biopsy is still the most reliable tool for diagnosis of lupus nephritis, several biomarkers have been validated for diagnosis and monitoring.