Kidney involvement is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). Collectively termed lupus nephritis, SLE with kidney involvement comes in many subtypes. The current classification by the International Society of Nephrology/Renal Pathology Society (ISN/RPS), however, does not include lupus podocytopathy, which, through various clinical and epidemiologic studies, has recently been…
In 2022, an international group of researchers reported the seminal finding that a gain-of-function variant of a single-stranded ribonucleic acid (RNA) sensor, known as toll-like receptor 7 (TLR7), can cause human systemic lupus erythematosus (SLE).1 The paper in Nature showed that a newly described variant of TLR7, identified in a child with severe lupus, was…
Antiphospholipid syndrome (APS) is an acquired thromboinflammatory disease that can have severe, sometimes catastrophic, effects on patients and their families. Our modern understanding of APS began to emerge in the early 1980s. At that point, it was defined as a condition characterized by thrombotic episodes and/or pregnancy complications in the presence of antiphospholipid antibodies (aPL).1…
The FDA has approved tocilizumab-aazg (Tyenne), the first tocilizumab biosimilar, for treating rheumatic diseases, as well as the new drug application for CB-101, a chimeric antigen receptor T cell therapy, for treating lupus nephritis and extra-renal lupus.
Current knowledge of receptor-ligand interactions, cell signaling, and transcriptional regulation derive from studies of type I interferon. The design of novel therapeutics is informed by the advances in investigation of type I interferon, with the potential for important impacts on patient management.
Checking blood levels of commonly used disease-modifying anti-rheumatic drugs (DMARDs) has gained widespread attention in the rheumatology community, even resulting in a recent guidance document from EULAR for biologics.1 Although a highly useful tool, drug level measurement in rheumatology is not without challenges; many of our drugs violate the basic principles of pharmacology that we…
Patients with systemic lupus erythematosus (SLE) often face many concerns, fears and uncertainties that render “treatment decision making very difficult,” says Jasvinder Singh, MD, MPH, professor of medicine and epidemiology at the University of Alabama at Birmingham. Often these patients, who tend to be women from minority groups, “do not have access to easily understandable…
Experts described the latest breakthroughs related to lupus and the brain, including the use of functional magnetic resonance imaging (fMRI) to gain insights into brain fog. Research into the role of microglia in neuropsychiatric lupus is also described.
Through a project to reduce gaps and inequities in lupus care and treatment, ACR work groups have developed five quality measures focused on clinical and patient-reported outcomes and are integrating them into the RISE registry to support patient care and research.
In this ACR Convergence 2023 session, experts offered guidance on a selection of diagnostic & treatment challenges rheumatologists may encounter.