Can we manage lupus nephritis without chronic corticosteroids administration?

Area of Science:

• Immunology
• Nephrology
• Rheumatology

Background:

• Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus (SLE).
• Glucocorticoids (GCs) have significantly reduced LN-related mortality since their introduction.
• While effective, GCs and other immunosuppressants have treatment-related toxicities.

Purpose of the Study:

• To review the benefits and drawbacks of chronic glucocorticoid (GC) use in treating SLE and LN.
• To highlight the dual nature of GCs in managing disease activity versus causing side effects.

Main Methods:

• Review of existing literature on glucocorticoid therapy in SLE and LN.
• Analysis of the efficacy and toxicity profiles of chronic GC administration.

Main Results:

• GCs offer rapid and effective control of SLE and LN inflammation.
• Chronic GC use is associated with significant and severe side effects, leading to organ damage.

Conclusions:

• GCs remain a cornerstone treatment for SLE and LN despite their toxicity.
• A careful balance is required to maximize GC benefits while minimizing harm in LN management.