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Two cases demonstrating thalidomide's efficacy in refractory lupus nephritis.

Rita Raturi1, Avani A Patel1, John D Carter2

  • 1Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 17 Davis Blvd., Suite 308, Tampa, FL, 33606, USA.

Clinical Rheumatology
|December 22, 2016
PubMed
Summary

Systemic lupus erythematosus (SLE) can affect the kidneys, leading to lupus nephritis (LN). In refractory cases, thalidomide (THD) showed promise in improving proteinuria.

Keywords:
LupusLupus nephritisProteinuriaThalidomide

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Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Renal involvement in SLE, or lupus nephritis (LN), is a common complication associated with increased mortality.
  • Standard induction therapies like cyclophosphamide (CYC) and mycophenolate mofetil (MMF) are ineffective in approximately 30% of patients.
  • Early diagnosis and effective treatment are crucial to prevent progression to end-stage renal disease.

Observation:

  • Two cases of lupus nephritis (LN) patients presented with persistent proteinuria despite standard treatments.
  • These patients experienced significant proteinuria reduction after the addition of thalidomide (THD).

Findings:

  • Thalidomide (THD) was well-tolerated and associated with a reduced protein-to-creatinine ratio in both cases.
  • A literature review indicated THD with prednisolone (PL) was more efficacious than MMF with PL in a lupus nephritis mouse model.
  • Sustained results were observed in both patient cases treated with thalidomide.

Implications:

  • These findings suggest thalidomide (THD) may be a potential therapeutic option for refractory lupus nephritis (LN).
  • Further clinical studies are warranted to explore the efficacy and safety of thalidomide in treating LN.
  • Thalidomide could offer a new treatment avenue for patients unresponsive to standard lupus nephritis therapies.