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Autoimmun Rev. 2018 Jan;17(1):4-10. doi: 10.1016/j.autrev.2017.11.002. Epub 2017 Nov 3.

Can we manage lupus nephritis without chronic corticosteroids administration?

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Imperial College Lupus Centre, Section of Renal Medicine and Vascular Inflammation, Department of Medicine, Faculty of Medicine, Imperial College London, London, UK.
Division of Rheumatology, Department of Medicine, University of Padova, Padova, Italy. Electronic address:
Division of Nephrology, Department of Medicine, University Health Network, Toronto, Canada.
Division of Rheumatology, Department of Medicine, University of Padova, Padova, Italy.


The outcome of lupus nephritis (LN) has changed since the introduction of glucocorticoids (GCs), which dramatically reduced the mortality related to one of the most severe complications of systemic lupus erythematosus (SLE). Since the 1950's, other immunosuppressants, including biologic drugs (i.e. rituximab) have aided in maintaining remission, preserving kidney function, but not preventing treatment-related toxicity. GCs still remain the cornerstone in the treatment of SLE, including LN, and they are widely used in clinical practice. However, GC administration represents a double-edged sword. Indeed, from one side they allow a fast and effective control of disease activity by dampening inflammation; from the other side, they have many and severe side effects leading to organ damage. In this paper, we will discuss pros and cons of the chronic use of GCs, especially focusing on LN.


Adverse events; Corticosteroids; Lupus nephritis; Management

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