Abstract summary 

Lupus nephritis (LN) is present in over 50% of patients with systemic lupus erythematosus (SLE) which is managed with immunosuppressive and immunomodulatory therapies. However, several novel therapeutic approaches for LN are under investigation due to the adverse effects spectrum of conventional therapy; Methods: We performed a comprehensive review of meta-analyses aggregating the comparative efficacies of various pharmacotherapies for LN. We conducted a literature search and retrieved a total of 23 meta-analyses and network meta-analyses for summarization. Pharmacotherapies were evaluated across six major outcomes: remission, relapse, mortality, end stage kidney disease (ESKD) progression, infection, and malignancy.Calcineurin inhibitors (CNI), particularly tacrolimus (TAC), in combination with glucocorticoids (GC) outperformed cyclophosphamide (CPA) with GC in the rate of remission, either complete or partial remission, and in terms of infectious complications. In maintenance therapy, MMF was superior to azathioprine (AZA) as the MMF-treated patients had lower relapse rate.This review aggregates evidence of therapy for clinicians and sheds light on comparative efficacies of alternative LN treatments. As more promising agents are entering the market, such as voclosporin, belimumab, and obinutuzumab, LN management might undergo significant changes during the next years.

Authors & Co-authors:  Shin Jae Il JI Li Han H Park Seoyeon S Yang Jae Won JW Lee Keum Hwa KH Jo Yongsuk Y Park Seongeun S Oh Jungmin J Kim Hansol H An Hyo Jin HJ Jeong Gahee G Jung Haerang H Lee Hyun Jung HJ Kim Jae Seok JS Nam Seoung Wan SW Koyanagi Ai A Jacob Louis L Hwang Jimin J Yon Dong Keon DK Lee Seung-Won SW Tizaoui Kalthoum K Kronbichler Andreas A Kim Ji Hong JH Smith Lee L

Study Outcome 

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