Leanna Wise, MD, emphasizes the importance of comprehensive screening for lupus nephritis (LN) in patients with systemic lupus erythematosus (SLE). Recommending frequent screening, she employs urinalysis and urine protein creatinine ratio every 2 to 3 months, particularly for at-risk groups like certain ethnic minorities, younger individuals, and males. Dr Wise underscores the severity and high prevalence of LN, which affect overall SLE management. When tailoring individual treatments, she considers biopsy results, degree of proteinuria, prior therapies, and comorbidities. She advocates for combination therapy and minimizing long-term steroid use, stressing the importance of steroid tapering.
Discussing FDA-approved treatments for LN, Dr Wise states that belimumab is effective for lower proteinuria, while voclosporin suits higher degrees. She also highlights the benefits of coordinating care with nephrologists and noted that patient education should involve emphasizing disease chronicity, proactive management, lifestyle modifications, and building strong support networks.
Dr Wise anticipates clinical trial data for anifrolumab in LN and notes small studies on fish oil supplements. Her crucial takeaway is the importance frequent screening and early, aggressive treatment for optimal lupus nephritis outcomes, focusing on achieving low proteinuria levels within a year for better long-term results.
This summary was AI-generated and reviewed by an AJMC editor.
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