切换至 "中华医学电子期刊资源库"

中华肾病研究电子杂志 ›› 2026, Vol. 15 ›› Issue (01) : 46 -56. doi: 10.3877/cma.j.issn.2095-3216.2026.01.008

综述

狼疮性肾炎的治疗进展
韩培杰1, 苏晓乐2, 王利华2,(), 裴欢欣1   
  1. 1030001 太原,山西医科大学
    2030000 太原,山西医科大学第二医院肾内科
  • 收稿日期:2025-01-28 出版日期:2026-02-28
  • 通信作者: 王利华
  • 基金资助:
    国家自然科学基金(82170746)

Advances in treatment of lupus nephritis

Peijie Han1, Xiaole Su2, Lihua Wang2,(), Huanxin Pei1   

  1. 1Shanxi Medical University, Taiyuan 030001
    2Department of Nephrology, Second Hospital of Shanxi Medical University, Taiyuan 030000; Shanxi Province, China
  • Received:2025-01-28 Published:2026-02-28
  • Corresponding author: Lihua Wang
引用本文:

韩培杰, 苏晓乐, 王利华, 裴欢欣. 狼疮性肾炎的治疗进展[J/OL]. 中华肾病研究电子杂志, 2026, 15(01): 46-56.

Peijie Han, Xiaole Su, Lihua Wang, Huanxin Pei. Advances in treatment of lupus nephritis[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2026, 15(01): 46-56.

狼疮性肾炎(lupus nephritis,LN)是系统性红斑狼疮(systemic lupus erythematosus,SLE)最为常见且严重的并发症之一,不仅是导致SLE患者发病率与死亡率升高的关键因素,亦可进展至终末期肾病,严重影响预后。近年来,随着对LN发病机制的不断深入探索,新型治疗药物与干预策略相继涌现,个体化、精准化治疗理念逐渐成为研究焦点。本文系统综述LN治疗领域的最新研究进展,以期为临床实践优化及未来研究方向提供有力依据与参考。

Lupus nephritis (LN) is one of the most common and severe complications of systemic lupus erythematosus (SLE). It is a major contributor to both morbidity and mortality among SLE patients, and can progress to end-stage renal disease, thereby significantly impairing prognosis. In recent years, with the deepening understanding of the pathogenesis of LN, novel therapeutic agents and strategies have emerged rapidly, making personalized and precision medicine a research hotspot. This review summarized the latest advances in the treatment of LN, aiming to provide a robust reference for optimizing clinical practice and guiding future research directions.

表1 狼疮性肾炎治疗的主要国际指南推荐
类型 EULAR/ERA-EDTA指南72023[5] APLAR指南2024[8,9] KDIGO指南2024[4] ACR指南2012[7]
初始治疗 HCQ HCQ HCQ HCQ
Ⅲ/Ⅳ±Ⅴ型 一线:GCs和MMF(2~3 g/d),或低剂量静脉注射环磷酰胺 一线:GCs和MMF(2 g/d)或高剂量静脉注射环磷酰胺 一线:GCs(低剂量)和MMF(2~3 g/d)或低剂量静脉注射环磷酰胺 GCs和MMF(2~3 g/d),大剂量冲击环磷酰胺(欧洲白人用低剂量)
  二线:①MMF和CNI(TAC)(肾病范围蛋白尿);②高剂量静脉注射环磷酰胺(肾衰竭高风险) 二线:低剂量静脉注射环磷酰胺或TAC 二线:①MMF和CNI(TAC);②高剂量静脉注射环磷酰胺或口服环磷酰胺  
纯Ⅴ型 一线:MMF(2~3 g/d) 一线:GCs和MMF(2 g/d)或高剂量静脉注射环磷酰胺 GCs和MMF或环磷酰胺或CNI或AZA或RTX GCs和MMF(2~3 g/d)
  二线:①静脉注射环磷酰胺;②CNI (TAC);③CNI(TAC)和MMF(肾病范围蛋白尿) 二线:低剂量静脉注射环磷酰胺或TAC    
难治性LN 在MMF和环磷酰胺间切换;或加用BEL/RTX;或换用IVIG(免疫抑制禁忌时,如感染风险) 在MMF和环磷酰胺间切换;或采用MMF联合TAC方案;或启用RTX/BEL 在MMF和环磷酰胺间切换;或增用VCS/BEL/抗CD20药(如RTX) 在MMF和环磷酰胺间切换,或增用RTX/CNI
维持治疗 MMF(1~2 g/d)或AZA(2 mg/kg·d)和泼尼松(2.5~5.0 mg/d)持续3~5年 一线:MMF或AZA持续5年 一线:MMF至少3年 MMF(1~2 g/d)或AZA(2 mg/kg·d)和低剂量GCs至少3年,个体化
    二线:低剂量TAC 二线:AZA或TAC  
快速进展LN 考虑高剂量静脉注射环磷酰胺
表2 狼疮性肾炎诱导治疗方案对比[4,6,13,25,30]
治疗方案 主要适用LN分型/人群 常用剂量(诱导) 主要疗效指标 主要不良反应/注意事项 KDIGO 2024推荐级别 备注
GCs和MMF Ⅲ/Ⅳ型(±Ⅴ型)LN;可作为多数患者的一线选择;尤其适用于有生育要求的年轻女性 GCs:甲泼尼龙冲击后口服泼尼松快速减量;MMF:2~3 g/d (亚洲患者可考虑2 g/d) 肾脏缓解率(CRR/PERR)
较高
感染风险,骨髓抑制(MMF相对较低),消化道反应(MMF),GCs相关副作用(高血糖、高血压及骨质疏松等) 1B MMF谷浓度监测价值尚不明确
GCs和低剂量静脉注射环磷酰胺(Euro-Lupus) Ⅲ/Ⅳ型(±Ⅴ型)LN;可作为一线选择 GCs:同上;静脉注射环磷酰胺:500 mg q2w,共6次 肾脏缓解率与高剂量环磷酰胺或MMF方案相当(在特定人群) 感染风险,骨髓抑制,恶心呕吐,脱发,生殖毒性(低剂量方案风险相对较低),膀胱毒性(罕见于低剂量) 1B 主要基于欧洲白人数据,其他人群证据逐渐积累
GCs和高剂量静脉注射环磷酰胺(NIH方案) Ⅲ/Ⅳ型(±Ⅴ型)LN;传统一线方案,尤其适用于病情严重或对其他方案反应不佳者 GCs:同上;静脉注射环磷酰胺:0.5~1.0 g/m2每月1次,共6个月 肾脏缓解率高 感染风险(较高),骨髓抑制(较重),恶心呕吐,脱发,生殖毒性(风险较高),膀胱毒性,远期肿瘤风险 作为备选 累积剂量需关注
GCs和MMF和CNI(VCS/TAC) Ⅲ/Ⅳ型(±Ⅴ型)LN;尤其适用于肾功能尚可(eGFR > 45)伴肾病范围蛋白尿(提示足细胞损伤) GCs:同上;MMF:可略减量;VCS:23.7 mg bid;TAC:目标谷浓度约5.5 ng/ml(中国数据) 早期蛋白尿下降更显著,肾脏缓解率可能更高(AURORA-1:VCS组CRR 41%比安慰剂组23% at 52 w) 肾毒性(需监测eGFR,CNI浓度),高血压,高钾血症,震颤,感染风险,GCs/MMF相关副作用 1B VCS不建议用于eGFR≤45 ml/(min·1.73)m2患者;TAC方案数据主要来自亚洲人群
GCs和MMF/低剂量静脉注射环磷酰胺和BEL Ⅲ/Ⅳ型(±Ⅴ型)LN;可作为一线选择,尤其适用于复发风险高或病情持续活动者 GCs:同上;MMF/低剂量静脉注射环磷酰胺:同上;BEL:10 mg/kg静脉注射q2w x3次,然后q4w(或皮下注射) 提高肾脏应答率,降低复发风险(BLISS-LN:BEL组PERR 43%比安慰剂组32% at 104w) 感染风险(可能略增),输液反应/注射部位反应,GCs/MMF/环磷酰胺相关副作用 1B BEL对部分亚组(如膜性成分重、基线蛋白尿极高、环磷酰胺联用或非亚/非裔)疗效可能稍差(亚组分析提示)
GCs和RTX(挽救治疗) 难治性/复发性Ⅲ/Ⅳ型(±Ⅴ型)LN GCs:同上;RTX:常用375 mg/m2 q1w x4或1g q2w x2次 在难治患者中可获得一定缓解率(Meta分析:CRR约46%,PRR约32%) 感染风险(尤其机会性感染),输液反应,血清病,PML(罕见),B细胞耗竭不全可能影响疗效 作为挽救选择 KDIGO 2024推荐作为对初始常规治疗反应不佳时的选择
表3 狼疮性肾炎维持治疗方案对比[4,14,30]
治疗方案 主要适用LN分型/人群 常用剂量(维持) 主要疗效指标 主要不良反应/注意事项 KDIGO 2024推荐级别 备注
MMF和低剂量GCs Ⅲ/Ⅳ型(±Ⅴ型)LN缓解后;Ⅴ型LN缓解后 MMF:1~2 g/d;GCs:泼尼松≤5~7.5 mg/d,争取停用 降低复发率优于AZA(部分研究) 感染风险,消化道反应,GCs长期副作用 1B(首选) 维持治疗至少3~5年
AZA和低剂量GCs Ⅲ/Ⅳ型(±Ⅴ型)LN缓解后;Ⅴ型LN缓解后;MMF不耐受/无法获取/计划妊娠时替代MMF AZA:1.5~2.5 mg/(kg·d);GCs:泼尼松≤5~7.5 mg/d,争取停用 有效维持缓解,降低复发率 骨髓抑制(需监测血常规),肝功能损害,胰腺炎(少见),感染风险,GCs长期副作用 1B(替代) 妊娠期相对安全;TPMT基因型检测有助于预测毒性
MMF/AZA和BEL和低剂量GCs Ⅲ/Ⅳ型(±Ⅴ型)LN,若诱导治疗含BEL且有效,可考虑继续用于维持 MMF/AZA:同上;BEL:10 mg/kg静脉注射q4w(或皮下注射);GCs:同上 持续控制疾病活动,降低复发风险 感染风险,输液反应/注射部位反应,MMF/AZA/GCs相关副作用 (实践要点) BLISS-LN研究中BEL持续使用至104周
MMF和CNI和低剂量GCs Ⅲ/Ⅳ型(±Ⅴ型)LN,若诱导治疗含CNI且有效,可考虑继续用于维持 MMF:同上;VCS:23.7 mg bid;TAC:维持较低谷浓度;GCs:同上 持续控制蛋白尿,维持肾功能稳定 肾毒性(长期应用需警惕),高血压,高钾血症,感染风险,MMF/GCs相关副作用 (实践要点) AURORA 2研究中VCS持续使用至3年,显示长期疗效与安全性
表4 狼疮性肾炎其他新型治疗药物简介[34,43,44,45,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52]
表5 狼疮性肾炎的新型治疗药物及临床试验进展
治疗靶点 新药或治疗方案 关键试验 发展阶段
B细胞      
CD20 利妥昔单抗 LUNAR 3期临床试验(阴性结果)
  奥瑞珠单抗 BELONG 3期临床试验(提前终止)
  奥妥珠单抗 REGENCY 3期临床试验(进行中)
BAFF 贝利尤单抗 BLISS-LN 3期临床试验(已获批)
CD20和BAFF 利妥昔单抗和贝利尤单抗 CALIBRATE 2期临床试验(阴性结果)
    BEAT-LUPUS 2期临床试验(积极结果)
    BLISS-BELIEVE 3期临床试验(阴性结果)
BAFF受体 Ianalumab NCT05126277 3期临床试验(进行中)
BAFF/APRIL 阿塔西普 NCT00624338 2期/3期临床试验(阴性结果,非肾性SLE)
  泰它西普 NCT02885610 中国获批(非肾性SLE)
BAFF/ICOSL Rozibafusp alfa NCT03845517 2期临床试验(非肾性SLE)
CD38 达雷妥尤单抗 NCT04868838 2期临床试验单臂(进行中)
CD22 依帕珠单抗 NCT01262365 3期临床试验(阴性结果,非肾性SLE)
    NCT01261793 3期临床试验(阴性结果,非肾性SLE)
CD19 Obexelimab NCT02725515 2期临床试验(非肾性SLE)
T细胞      
钙调磷酸酶 他克莫司 NCT00876616 3期临床试验(亚洲部分获批)
  伏环孢素 AURORA-1 3期临床试验(美欧获批)
mTOR 西罗莫司 NCT04892212 2期/3期临床试验单臂
CD40 BI 655064 NCT02770170 2期临床试验(阴性结果)
  Iscalimab NCT03610516 2期临床试验
CD40L Dazodalbep NCT05201469 2期临床试验
  达珠单抗 NCT04294667 3期临床试验(非肾性SLE)
CD80/86 阿巴西普 NCT00774852 2期临床试验(阴性结果)
T细胞活化 Rigerimod EvduraCT number:2007-004892-21 2期临床试验(非肾性SLE)
IL-2 Efsaleukin alfa NCT04680637 2期临床试验(非肾性SLE)
  低剂量IL-2 NCT04077684 2期临床试验(非肾性SLE)
树突细胞      
BDCA-2 Litiflimab NCT04895241 3期临床试验(非肾性SLE,进行中)
2期/3期临床试验LN计划中
ILT7 VIB7734 NCT04925934 2期临床试验(非肾性SLE,进行中)
细胞因子      
Ⅰ型干扰素受体 阿尼鲁单抗 BLISS-LN 2期临床试验(阴性结果)
IL-17 司库奇尤单抗 NCT04181762 3期临床试验(进行中)
IL-23 Guselkumab NCT04376827 2期临床试验
IL-12/IL-23 乌司奴单抗 NCT03517722 3期临床试验(阴性结果,非肾性SLE)
细胞内信号      
JAK1/JAK2 巴瑞替尼 NCT05432531 1期临床试验
    NCT03616912/64 3期临床试验(阴性结果,非肾性SLE)
JAK1/酪氨酸激酶2 Brepocinib NCT03845517 2期临床试验(非肾性SLE)
酪氨酸激酶2 Deucravacitinib NCT03920267 2期临床试验(积极结果,非肾性SLE)
BTK Fenebrutinib NCT02908100 2期临床试验(阴性结果,非肾性SLE)
  Evobrutinib NCT02975336 2期临床试验(阴性结果,非肾性SLE)
  奥布替尼 NCT04305197 2期临床试验(非肾性SLE)
补体通路      
C5 依库珠单抗 个案报告(SLE/LN)
  雷夫利珠单抗 NCT04564339 2期临床试验(进行中)
B因子 Iptacopan NCT05268289 2期临床试验
其他疗法      
细胞治疗 间充质干细胞 NCT03917797 2期临床试验(进行中)
    NCT03673748 2期临床试验
  CAR-T NCT05085418 1期临床试验
    NCT05030779 1期临床试验
免疫蛋白酶体 KZR-616 NCT03393013 2期临床试验(进行中)
FcRn Nipocalimab NCT04883619 2期临床试验
图1 狼疮性肾炎治疗流程图[4]注:LN:lupus nephritis,狼疮性肾炎;SLE:systemic lupus erythematosus,系统性红斑狼疮;GCs:glucocorticoids,糖皮质激素;CKD:chronic kidney disease,慢性肾脏病;CNI:calcineurin inhibitor,钙调神经磷酸酶抑制剂;MMF:mycophenolate mofetil,吗替麦考酚酯;CYC:cyclophosphamide,环磷酰胺;AZA:azathioprine,硫唑嘌呤;HCQ:hydroxychloroquine,羟氯喹;BEL:belimumab,贝利尤单抗;RAS:renin-angiotensin system,肾素-血管紧张素系统;TMA:thrombotic microangiopathy,血栓性微血管病;ADAMTS13:a disintegrin and metalloproteinase with thrombospondin type 1 motif 13,含血小板反应蛋白13号基序的解聚素金属蛋白酶;该图展示了狼疮肾炎基于病理分型的临床诊疗决策路径,涵盖Ⅰ/Ⅱ型、Ⅲ/Ⅳ型和Ⅴ型的主要治疗原则、维持治疗策略及合并TMA等特殊情况的处理流程
[1]
Jakes RW, Bae SC, Louthrenoo W, et al. Systematic review of the epidemiology of systemic lupus erythematosus in the Asia-Pacific region: prevalence, incidence, clinical features, and mortality [J]. Arthritis Care Res, 2012, 64(2): 159-168.
[2]
Hoi A, Legel T, Mok CCM, et al. Systemic lupus erythematosus [J]. Lancet, 2024, 403(10441): 2326-2338.
[3]
Kostopoulou M, Fanouriakis A, Cheema K, et al. Management of lupus nephritis: a systematic literature review informing the 2019 update of the joint EULAR and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations [J]. RMD Open, 2020, 6(2): e001263.
[4]
Kidney Disease: Improving Global Outcomes CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease [J]. Kidney Int, 2024, 105(4): S117-S314.
[5]
Fanouriakis A, Kostopoulou M, Andersen J, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update [J]. Ann Rheum Dis, 2024, 83(1): 15-29.
[6]
Houssiau FA, Vasconelos C, D′Cruz D, et al. The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide [J]. Ann Rheum Dis, 2010, 69(1): 61-64.
[7]
Hahn BH, McMahon MA, Wilkinson A, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis [J]. Arthritis Care Res, 2012, 64(6): 797-808.
[8]
Mok CC, Hamijoyo L, Kasitanon N, et al. The Asia-Pacific League of Associations for Rheumatology consensus statements on the management of systemic lupus erythematosus [J]. Lancet Rheumatol, 2021, 3(7): e517-e531.
[9]
Mok CC, So H, Hamijoyo L, et al. The 2024 APLAR consensus on the management of lupus nephritis [J]. Int J Rheum Dis, 2025, 28(1): e70021.
[10]
Mok CC, Ho LY, Ying SKY, et al. Long-term outcome of a randomised controlled trial comparing tacrolimus with mycophenolate mofetil as induction therapy for active lupus nephritis [J]. Ann Rheum Dis, 2020, 79(8): 1070-1076.
[11]
Liu Z, Zhang H, Liu Z, et al. Multitarget therapy for induction treatment of lupus nephritis: a randomized trial [J]. Ann Intern Med, 2015, 162(1): 18-26.
[12]
Fanouriakis A, Kostopoulou M, Cheema K, et al. 2019 update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis [J]. Ann Rheum Dis, 2020, 79(6): 713-723.
[13]
Rovin BH, Teng YKO, Ginzler EM, et al. Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial [J]. Lancet, 2021, 397(10289): 2070-2080.
[14]
Saxena A, Ginzler EM, Gibson K, et al. Safety and efficacy of long-term voclosporin treatment for lupus nephritis in the phase 3 AURORA 2 clinical trial [J]. Arthritis Rheumatol, 2024, 76(1): 59-67.
[15]
Abdel-Kahaar E, Keller F. Clinical pharmacokinetics and pharmacodynamics of voclosporin [J]. Clin Pharmacokinet, 2023, 62(5): 693-703.
[16]
van Gelder T, Lerma E, Engelke K, et al. Voclosporin: a novel calcineurin inhibitor for the treatment of lupus nephritis [J]. Expert Rev Clin Pharmacol, 2022, 15(5): 515-529.
[17]
Arriens C, Teng YKO, Ginzler EM, et al. Update on the efficacy and safety profile of voclosporin: an integrated analysis of clinical trials in lupus nephritis [J]. Arthritis Care Res (Hoboken), 2023, 75(7): 1399-1408.
[18]
Rovin BH, Solomons N, Pendergraft WF III, et al. A randomized, controlled double-blind study comparing the efficacy and safety of dose-ranging voclosporin with placebo in achieving remission in patients with active lupus nephritis [J]. Kidney Int, 2019, 95(1): 219-231.
[19]
Rovin BH, Furie R, Latinis K, et al. Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the lupus nephritis assessment with rituximab study [J]. Arthritis Rheum, 2012, 64(4): 1215-1226.
[20]
Gomez Mendez LM, Cascino MD, Garg J, et al. Peripheral blood B cell depletion after rituximab and complete response in lupus nephritis [J]. Clin J Am Soc Nephrol, 2018, 13(10): 1502-1509.
[21]
Roveta A, Parodi EL, Brezzi B, et al. Lupus nephritis from pathogenesis to new therapies: an update [J]. Int J Mol Sci, 2024, 25(16): 8981.
[22]
Rydén-Aulin M, Boumpas D, Bultink I, et al. Off-label use of rituximab for systemic lupus erythematosus in Europe [J]. Lupus Sci Med, 2016, 3(1): e000163.
[23]
Díaz-Lagares C, Croca S, Sangle S, et al. Efficacy of rituximab in 164 patients with biopsy-proven lupus nephritis: pooled data from European cohorts [J]. Autoimmun Rev, 2012, 11(5): 357-364.
[24]
Terrier B, Amoura Z, Ravaud P, et al. Safety and efficacy of rituximab in systemic lupus erythematosus: results from 136 patients from the French autoimmunity and rituximab registry [J]. Arthritis Rheum, 2010, 62(8): 2458-2466.
[25]
Alshaiki F, Obaid E, Almuallim A, et al. Outcomes of rituximab therapy in refractory lupus: a meta-analysis [J]. Eur J Rheumatol, 2018, 5(2): 118-126.
[26]
Yu X, Chen N, Xue J, et al. Efficacy and safety of belimumab in patients with lupus nephritis: subgroup analyses of a phase 3 randomized trial in the East Asian population [J]. Am J Kidney Dis, 2023, 81(3): 294-306.e1.
[27]
Rovin BH, Furie R, Teng YKO, et al. A secondary analysis of the belimumab international study in lupus nephritis trial examined effects of belimumab on kidney outcomes and preservation of kidney function in patients with lupus nephritis [J]. Kidney Int, 2022, 101(2): 403-413.
[28]
Tan M, Xu J, Tan Y, et al. Efficacy and safety of belimumab in lupus nephritis patients: a real-world observational study in China [J]. Kidney Dis (Basel), 2023, 9(3): 218-228.
[29]
Furie R, Rovin BH, Houssiau F, et al. Two-year, randomized, controlled trial of belimumab in lupus nephritis [J]. N Engl J Med, 2020, 383(12): 1117-1128.
[30]
Furie R, Rovin BH, Houssiau F, et al. Safety and efficacy of belimumab in patients with lupus nephritis: open-label extension of BLISS-LN study [J]. Clin J Am Soc Nephrol, 2022, 17(11): 1620-1630.
[31]
Zhang K, Qi T, Guo D, et al. Efficacy and safety of belimumab therapy for patients with lupus nephritis: a meta-analysis and a propensity score-matched case-control study [J]. Immun Inflamm Dis, 2023, 11(7): e954.
[32]
Lin S, Zhang J, You X, et al. Efficacy and safety of belimumab in patients with lupus nephritis: a real-world retrospective observational study [J]. Rheumatology (Oxford), 2025, 64(2): 614-622.
[33]
Mok CC, Ho LY, Chan KL, et al. Trend of survival of a cohort of Chinese patients with systemic lupus erythematosus over 25 years [J]. Front Med (Lausanne), 2020, 7: 552.
[34]
Furie RA, Aroca G, Cascino MD, et al. B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial [J]. Ann Rheum Dis, 2022, 81(1): 100-107.
[35]
Condon MB, Ashby D, Pepper RJ, et al. Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids [J]. Ann Rheum Dis, 2013, 72(8): 1280-1286.
[36]
Moroni G, Doria A, Mosca M, et al. A randomized pilot trial comparing cyclosporine and azathioprine for maintenance therapy in diffuse lupus nephritis over four years [J]. Clin J Am Soc Nephrol, 2006, 1(5): 925-932.
[37]
Argolini LM, Frontini G, Elefante E, et al. Multicentric study comparing cyclosporine, mycophenolate mofetil and azathioprine in the maintenance therapy of lupus nephritis: 8 years follow up [J]. J Nephrol, 2021, 34(2): 389-398.
[38]
Takeuchi T, Wakasugi N, Uno S, et al. Long-term safety and effectiveness of tacrolimus in patients with lupus nephritis: 5-year interim postmarketing surveillance study in Japan (TRUST) [J]. J Rheumatol, 2021, 48(1): 74-81.
[39]
Fu Q, Wu C, Dai M, et al. Leflunomide versus azathioprine for maintenance therapy of lupus nephritis: a prospective, multicentre, randomised trial and long-term follow-up [J]. Ann Rheum Dis, 2022, 81(11): 1549-1555.
[40]
Jourde-Chiche N, Costedoat-Chalumeau N, Baumstarck K, et al. Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial [J]. Ann Rheum Dis, 2022, 81(10): 1420-1427.
[41]
Mejia-Vilet JM, Turner-Stokes T, Houssiau F, et al. Kidney involvement in systemic lupus erythematosus: from the patient assessment to a tailored treatment [J]. Best Pract Res Clin Rheumatol, 2023, 37(4): 101925.
[42]
Rojas-Rivera JE, García-Carro C, Ávila AI, et al. Diagnosis and treatment of lupus nephritis: a summary of the consensus document of the Spanish group for the study of glomerular diseases (GLOSEN) [J]. Clin Kidney J, 2023, 16(9): 1384-1402.
[43]
Arnold J, Dass S, Twigg S, et al. Efficacy and safety of obinutuzumab in systemic lupus erythematosus patients with secondary non-response to rituximab [J]. Rheumatology (Oxford), 2022, 61(12): 4905-4909.
[44]
Wu D, Li J, Xu D, et al. Telitacicept in patients with active systemic lupus erythematosus: results of a phase 2b, randomised, double-blind, placebo-controlled trial [J]. Ann Rheum Dis, 2024, 83(4): 475-487.
[45]
Huang X, Lin F, Chen H. Efficacy and safety of telitacicept in patients with lupus nephritis: a single-center, real-world retrospective study [J]. Clin Exp Nephrol, 2024, 28(9): 902-909.
[46]
Kraaij T, Arends EJ, van Dam LS, et al. Long-term effects of combined B-cell immunomodulation with rituximab and belimumab in severe, refractory systemic lupus erythematosus: 2-year results [J]. Nephrol Dial Transplant, 2021, 36(8): 1474-1483.
[47]
Atisha-Fregoso Y, Malkiel S, Harris KM, et al. Phase II randomized trial of rituximab plus cyclophosphamide followed by belimumab for the treatment of lupus nephritis [J]. Arthritis Rheumatol, 2021, 73(1): 121-131.
[48]
Shipa M, Embleton-Thirsk A, Parvaz M, et al. Effectiveness of belimumab after rituximab in systemic lupus erythematosus: a randomized controlled trial [J]. Ann Intern Med, 2021, 174(12): 1647-1657.
[49]
Aranow C, Allaart CF, Amoura Z, et al. Efficacy and safety of sequential therapy with subcutaneous belimumab and one cycle of rituximab in patients with systemic lupus erythematosus: the phase 3, randomised, placebo-controlled BLISS-BELIEVE study [J]. Ann Rheum Dis, 2024, 83(11): 1502-1512.
[50]
Morand EF, Furie R, Tanaka Y, et al. Trial of anifrolumab in active systemic lupus erythematosus [J]. N Engl J Med, 2020, 382(3): 211-221.
[51]
Kalunian KC, Furie R, Morand EF, et al. A randomized, placebo-controlled phase III extension trial of the long-term safety and tolerability of anifrolumab in active systemic lupus erythematosus [J]. Arthritis Rheumatol, 2023, 75(2): 253-265.
[52]
Jayne D, Rovin B, Mysler EF, et al. Phase II randomised trial of type I interferon inhibitor anifrolumab in patients with active lupus nephritis [J]. Ann Rheum Dis, 2022, 81(4): 496-506.
[53]
van Vollenhoven RF, Hahn BH, Tsokos GC, et al. Efficacy and safety of ustekinumab, an IL-12 and IL-23 inhibitor, in patients with active systemic lupus erythematosus: results of a multicentre, double-blind, phase 2, randomised, controlled study [J]. Lancet, 2018, 392(10155): 1330-1339.
[54]
van Vollenhoven RF, Kalunian KC, Dörner T, et al. Phase 3, multicentre, randomised, placebo-controlled study evaluating the efficacy and safety of ustekinumab in patients with systemic lupus erythematosus [J]. Ann Rheum Dis, 2022, 81(11): 1556-1563.
[55]
Mackensen A, Müller F, Mougiakakos D, et al. Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus [J]. Nat Med, 2022, 28(10): 2124-2132.
[56]
Müller F, Taubmann J, Bucci L, et al. CD19 CAR T-cell therapy in autoimmune disease - a case series with follow-up [J]. N Engl J Med, 2024, 390(8): 687-700.
[57]
Solé C, Royo M, Sandoval S, et al. Precise targeting of autoantigen-specific B cells in lupus nephritis with chimeric autoantibody receptor T cells [J]. Int J Mol Sci, 2024, 25(8): 4226.
[58]
Wang W, He S, Zhang W, et al. BCMA-CD19 compound CAR T cells for systemic lupus erythematosus: a phase 1 open-label clinical trial [J]. Ann Rheum Dis, 2024, 83(10): 1304-1314.
[59]
Brudno JN, Kochenderfer JN. Toxicities of chimeric antigen receptor T cells: recognition and management [J]. Blood, 2016, 127(26): 3321-3330.
[60]
Yan MT, Chao CT, Lin SH, et al. Chronic kidney disease: strategies to retard progression [J]. Int J Mol Sci, 2021, 22(18): 10084.
[61]
孔维萍,张刘波,刘坚,等. 系统性红斑狼疮及其主要脏器损害的中西医结合诊治[J/OL]. 中华肾病研究电子杂志2024, 13(1): 9-15.
[62]
Tse KC, Li FK, Tang S, et al. Angiotensin inhibition or blockade for the treatment of patients with quiescent lupus nephritis and persistent proteinuria [J]. Lupus, 2005, 14(12): 947-952.
[63]
Chang JC, Weiss PF, Xiao R, et al. Use of renin angiotensin aldosterone system inhibitors in children with lupus and time to glucocorticoid discontinuation [J]. Kidney Int, 2022, 102(2): 395-404.
[64]
Del Vecchio L, Beretta A, Jovane C, et al. A role for SGLT-2 inhibitors in treating non-diabetic chronic kidney disease [J]. Drugs, 2021, 81(13): 1491-1511.
[65]
De Nicola L, Cozzolino M, Genovesi S, et al. Can SGLT2 inhibitors answer unmet therapeutic needs in chronic kidney disease? [J]. J Nephrol, 2022, 35(6): 1605-1618.
[66]
Säemann M, Kronbichler A. Call for action in ANCA-associated vasculitis and lupus nephritis: promises and challenges of SGLT-2 inhibitors [J]. Ann Rheum Dis, 2022, 81(5): 614-617.
[1] 黄嘉明, 段红霞, 赖逾鹏, 王大吉, 刘兴娇, 沈鑫, 王梅英. 狼疮性肾炎慢性化中肾脏固有细胞的间充质化研究进展[J/OL]. 中华肾病研究电子杂志, 2022, 11(06): 347-352.
[2] 张梦琴, 何燕, 张璐, 石桂秀. 狼疮性肾炎的生物标志物研究进展[J/OL]. 中华肾病研究电子杂志, 2022, 11(03): 161-166.
[3] 于峰. 狼疮肾炎新的诊疗指南解读——从《KDIGO 2021年肾小球疾病管理临床实践指南》谈起[J/OL]. 中华肾病研究电子杂志, 2022, 11(03): 178-178.
[4] 王尚, 项丽, 许国双. B淋巴细胞在狼疮性肾炎中的作用研究进展[J/OL]. 中华肾病研究电子杂志, 2020, 09(04): 181-185.
[5] 牟姗, 田磊. Ⅴ型狼疮肾炎的诊断与治疗[J/OL]. 中华肾病研究电子杂志, 2015, 04(06): 298-301.
[6] 樊均明, 马欣, 沈宏春. 特发性膜性肾病的非免疫抑制治疗及中医药治疗[J/OL]. 中华肾病研究电子杂志, 2015, 04(06): 286-289.
[7] 王晶晶, 章海涛. 狼疮性肾炎诊断和治疗的研究进展[J/OL]. 中华临床医师杂志(电子版), 2018, 12(12): 692-697.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?