New age of Lupus Nephritis: Updates in guidelines, biomarkers, and therapies.

IF 4.8 2区医学 Q1 RHEUMATOLOGY

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-05-06 DOI:10.1016/j.berh.2026.102153

Malika Ibrahim, Emily He, Diana Tran, Divya Vundamati, Jennifer Grossman

引用次数: 0

Abstract

Lupus nephritis (LN) is the most common visceral organ manifestation of systemic lupus erythematosus (SLE). It affects approximately 50% of SLE patients, accounting for significant morbidity and mortality especially in ethnic minorities. Building on decades of landmark trials, the field has continued to evolve. The 2024 American College Rheumatology (ACR) Lupus Nephritis guideline represents an important shift toward earlier triple therapy. The guideline also recommends routine proteinuria screening and reaffirms kidney biopsy as the diagnostic gold standard. In parallel, urinary biomarkers are emerging as potential tools to better track infrarenal pathology. Furthermore, the therapeutic pipeline continues to expand with emerging strategies targeting B-cells, cytokine receptors, and co-stimulatory mechanisms. In this article, we review updates from the ACR guideline, the emerging data on urinary biomarkers, and highlight novel targeted therapies in LN.

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狼疮性肾炎的新时代：指南、生物标志物和治疗方法的更新。

狼疮肾炎（LN）是系统性红斑狼疮（SLE）最常见的内脏器官表现。它影响了大约50%的SLE患者，特别是少数民族患者的发病率和死亡率很高。在数十年具有里程碑意义的试验的基础上，该领域不断发展。2024年美国风湿病学会（ACR）狼疮肾炎指南代表了向早期三联治疗的重要转变。该指南还建议常规蛋白尿筛查，并重申肾活检是诊断的金标准。与此同时，尿液生物标志物正在成为更好地跟踪肾下病理的潜在工具。此外，随着针对b细胞、细胞因子受体和共刺激机制的新策略的出现，治疗渠道继续扩大。在本文中，我们回顾了ACR指南的更新，泌尿生物标志物的新数据，并重点介绍了新的LN靶向治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.