狼疮性肾炎最新治疗进展:从免疫抑制到靶向治疗
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国家重点研发计划重点专项子课题(2024YFC2510306).


Treatment advances in lupus nephritis: from immunosuppression to targeted therapy
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Supported by Key Subproject of National Key Research and Development Program of China (2024YFC2510306).

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    摘要:

    狼疮性肾炎是系统性红斑狼疮的一种常见严重并发症,约有10%的严重患者可能在诊断后10年内进展至终末期肾病,发病率和死亡率均较高。在治疗领域,糖皮质激素、抗疟药等传统药物自早期一直在使用,新的治疗方法发展缓慢,直至贝利尤单抗获得批准。近年来,系统性红斑狼疮和狼疮性肾炎的治疗研究取得新的进展,一系列创新疗法相继涌现,包括抗B细胞激活因子抗体、抗CD20抗体、抗CD40抗体和抗干扰素抗体等生物制剂及小分子激酶抑制剂等。这些研究推动了系统性红斑狼疮和狼疮性肾炎治疗策略向个体化、精准化方向发展。然而,尽管治疗手段不断丰富,仍有许多患者的治疗需求未能得到充分满足。本文总结了近年来狼疮性肾炎的临床试验及事后分析结果,重点阐述了有潜力的狼疮性肾炎治疗策略的研究进展。

    Abstract:

    Lupus nephritis (LN) is a common and severe complication of systemic lupus erythematosus (SLE). Approximately 10% of patients with severe LN may progress to end-stage renal disease within 10 years of diagnosis, accompanied by high morbidity and mortality. In the field of treatment, glucocorticoids, antimalarials and other conventional agents have remained the mainstay since the early days, and new therapies emerged slowly until belimumab was approved. In recent years, there has been renewed progress in the research and treatment of SLE and LN, with a series of innovative therapies emerging, including biologics such as anti-B cell-activating factor antibodies, anti-CD20 antibodies, anti-CD40 antibodies, and anti-interferon antibodies, as well as small molecule kinase inhibitors. These developments have shifted treatment strategies towards more individualized and precise approaches. However, despite the expanding array of treatment options, many therapeutic needs remain inadequately met. This paper summarizes recent clinical trials and post-hoc analyses of LN, highlighting advances in promising therapeutic strategies.

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  • 收稿日期:2025-04-03
  • 最后修改日期:2025-04-11
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  • 在线发布日期: 2025-11-25
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