Kidney Week

Educational Symposium

Expanding Therapeutic Landscape in Lupus Nephritis: Utilization of B Cell Targeted Therapy

October 25, 2024 | 12:45 PM - 01:45 PM

Location: Marriott Grand Ballroom 13, Marriott Marquis

Session Description

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Up to half of SLE patients develop lupus nephritis, with 10% to 30% progressing to require dialysis or a kidney transplant. After diagnosis, monitoring of proteinuria and kidney function is performed to assess ongoing disease activity. Decreased proteinuria at 12 months of treatment correlates well with favorable long-term kidney outcomes. Treatment regimens for lupus nephritis typically include corticosteroids, cyclophosphamide, mycophenolate mofetil, and hydroxychloroquine. Renin angiotensin system blocking agents are usually included for their antiproteinuric and antihypertensive actions.

B cells play a central role in driving autoimmunity, lupus nephritis in particular. Loss of self-tolerance and autoantibody production have long been the focus of targeted therapy development in SLE. Interestingly, rituximab, a monoclonal antibody that targets the CD20 antigen on B cells, is still commonly used despite a negative study (LUNAR trial). Now, obinutuzumab, a type II humanized anti-CD20 monoclonal antibody that depletes B cells (NOBILITY trial), and belimumab, a human monoclonal antibody that inhibits the soluble form of a B-cell survival factor known as BLyS (BLISS-LN trial), have been shown to be effective in large, randomized trials. With so many options, the practicing nephrologist needs a firm understanding of how and when to use these drugs to optimize outcomes.

Support is provided by an educational grant from Genentech, a member of the Roche Group.

Learning Objective(s)

• Describe the pathogenesis of lupus nephritis, with an emphasis on B cells and loss of tolerance
• Discuss the mechanisms of action and clinical utility of emerging B cell targeting therapies for lupus nephritis

Learning Pathway(s)

• Glomerular Diseases

Moderator

• Isabelle Ayoub, MD, MPH, FASN

Presentations

• Introduction
  12:45 PM - 12:55 PM
  
  • Isabelle Ayoub, MD, MPH, FASN

Introduction

October 25, 2024 | 12:45 PM - 12:55 PM

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• Pathogenesis of Lupus Nephritis: Focus on B Cell Tolerance
  12:55 PM - 01:15 PM
  
  • Hans J. Anders, MD

Pathogenesis of Lupus Nephritis: Focus on B Cell Tolerance

October 25, 2024 | 12:55 PM - 01:15 PM

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• Treatment of Lupus Nephritis: Focus on B Cell Targeting Therapies
  01:15 PM - 01:35 PM
  
  • Dawn J. Caster, MD, FASN

Treatment of Lupus Nephritis: Focus on B Cell Targeting Therapies

October 25, 2024 | 01:15 PM - 01:35 PM

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• Audience Q&A
  01:35 PM - 01:45 PM
  

Audience Q&A

October 25, 2024 | 01:35 PM - 01:45 PM

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