Belimumab as Add-on Therapy in Lupus Nephritis

Nephritis, the most common serious manifestation of systemic lupus erythematosus (SLE), affects up to 50% of patients with this condition. Proliferative lupus nephritis typically manifests with microscopic hematuria, nonnephrotic proteinuria, renal insufficiency, and hypertension, whereas membranous lupus nephropathy manifests with nephrotic syndrome. Current treatment for proliferative lupus nephritis involves intensive immunosuppression, usually with cyclophosphamide or mycophenolate mofetil and high-dose glucocorticoids in a 3-to-6-month induction period, followed by a maintenance period of less intensive immunosuppression. Most patients have an initial response, but relapses are common, and treatment-resistant disease often occurs. Although long-term outcomes have improved since the 1980s, the development of . . .