After 4 Decades of Lupus Nephritis Trials, Is There a “Best” Therapy?

At some point during their disease course, more than half of all patients with systemic lupus erythematosus will have clinically evident kidney disease, generally termed lupus nephritis (LN). The treatment of LN has improved remarkably during the last 4 decades, in large part because of a consistent record of well-performed randomized trials evaluating a growing number of available induction and maintenance treatment regimens.1 The result is a markedly improved prognosis for patients with LN. Whereas kidney survival at 5 years was as low as 20% before 1980, current treatment strategies have improved this rate to as high as 80% in the past decade.

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