Paradigm Shift in Lupus Nephritis Management: KDIGO Guideline Updates with Roger A Levy, MD, PhD

Results of the BLISS-LN study revealed patients receiving belimumab (Benlysta) alongside standard therapy exhibited faster and more frequent improvement in inflammation in patients with lupus nephritis. Moreover, they were less likely to progress to end-stage kidney disease, marking a significant advancement.

Based on this evidence, the Kidney Disease: Improving Global Outcomes (KDIGO), a group of international nephrology experts, updated their treatment guidelines in January 2024. They now recommend early use of belimumab in the treatment of lupus nephritis, particularly for patients with class III or IV.

In an interview with HCPLive, Roger A Levy, MD, PhD, senior global medical director at GSK Specialty Medicine, discussed the recent guideline updates regarding the treatment and management of this condition.

Levy believes these guidelines represent a paradigm shift because, previously, non-selective immune suppressors, similar to those used in oncology but at lower doses and for extended durations, were prescribed. While this approach showed improvements compared to steroids alone, it still posed risks including increased infections, bone marrow depletion, and ovarian failure. By introducing belimumab early and incorporating it into a more extended maintenance period, clinicians can mitigate exposure to steroids, thus reducing associated side effects and minimizing the risk of damage and relapses.

“We are learning more about the disease mechanism,” Levy told HCPLive. “And knowing how to break this chain that, if we let [continue], would be continuously causing damage. We know that the damage, when present, predicts further damage and early mortality. So, we want to avoid that. We want our patients to live longer and with a better quality of life.”

Link to full article:
Part 1: https://www.hcplive.com/view/roger-a-...
Part 2: https://www.hcplive.com/view/roger-a-...

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