狼疮性肾炎:治疗更新。

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics
Fahad Aziz, Kunal Chaudhary
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引用次数: 17

摘要

背景:狼疮肾炎(LN)是许多系统性红斑狼疮患者的常见并发症,尽管肾脏限制性狼疮肾炎也有报道。早期诊断狼疮性肾炎是至关重要的,因为早期发现和有效的治疗可以改善这类患者的肾脏预后。目的:狼疮性肾炎的治疗在很大程度上取决于肾活检标本的组织学分类。在大多数情况下,1级和2级狼疮性肾炎不需要任何特异性治疗,但3级和4级狼疮性肾炎需要免疫抑制治疗。V类和VI类的治疗仍有争议。2012年,出台了6项狼疮性肾炎治疗指南。这些指南为每一类狼疮性肾炎提供了全面的治疗方案,但在许多方面彼此不同。本文的目的是回顾目前文献中六类狼疮性肾炎和耐药狼疮性肾炎的药物治疗方法,解决治疗反应不足问题的策略,药物相关的副作用,狼疮性肾炎的复发,以及一些未来的治疗选择。方法:我们回顾现有的文献和治疗指南狼疮性肾炎的细节,提出了一个全面的审查可用于不同类型的狼疮性肾炎的治疗方案。结论:初始治疗无效的狼疮性肾炎与较差的肾脏预后相关。几种治疗方法可用于诱导和维持不同类型LN的免疫抑制。LN的治疗应根据患者的风险-收益情况进行个体化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lupus Nephritis: A Treatment Update.

Background: Lupus nephritis (LN) is a common complication in many patients with systemic lupus erythematosus, although renal-limited lupus nephritis has been reported as well. Early diagnosis of lupus nephritis is critical as early detection and effective treatment can improve renal outcomes in such patients.

Objective: The treatment of lupus nephritis is largely determined based on the histological class present on the renal biopsy specimen. In most cases, Class I and II of lupus nephritis do not require any specific treatment, but class III and IV lupus nephritis require immunosuppressive therapy. Treatment of Class V and VI remains controversial. In 2012, six guidelines were introduced for the management of lupus nephritis. These guidelines offer comprehensive treatment plans for each class of Lupus nephritis but differ from each other in many aspects. The purpose of this article is to review the current literature of the available pharmacological treatments used in the six classes of lupus nephritis as well as resistant lupus nephritis, strategies to address the problems of inadequate therapeutic response, medication related side effects, relapses of lupus nephritis, and some future treatment options.

Methods: We reviewed the available literature and treatment guidelines on lupus nephritis in detail to present a comprehensive review of the available treatment options for different classes of lupus nephritis.

Conclusion: Lupus nephritis which does not respond to initial treatment is associated with worse renal outcomes. Several therapeutic approaches are available for the induction and maintenance immunosuppression of the different classes of LN. Management of LN should be individualized for each patient based on their risk-benefit profile.

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来源期刊
Current clinical pharmacology
Current clinical pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
3.60
自引率
0.00%
发文量
0
期刊介绍: Current Clinical Pharmacology publishes frontier reviews on all the latest advances in clinical pharmacology. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: pharmacokinetics; therapeutic trials; adverse drug reactions; drug interactions; drug metabolism; pharmacoepidemiology; and drug development. The journal is essential reading for all researchers in clinical pharmacology.
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