IL-17 in Lupus Nephritis Treatment and Management

Pathophysiological Role and Clinical Correlation

• The American College of Rheumatology recommends monitoring serum creatinine, urinalysis, proteinuria, and blood pressure in lupus nephritis patients, with anti-dsDNA antibody titers and complement levels sometimes correlating with disease activity and active renal disease 2, 7, 1
• Current guidelines for lupus nephritis management do not specifically address IL-17 monitoring, but standard monitoring includes serum creatinine, urinalysis, proteinuria, and blood pressure 5, 6, 7

Therapeutic Implications and Treatment Approach

• The European League Against Rheumatism suggests that anti-IL-17A monoclonal antibodies and anti-IL-17RA monoclonal antibodies have shown success in phase II trials for multiple autoimmune diseases, including rheumatoid arthritis and multiple sclerosis 1, 2
• Treatment guidelines for lupus nephritis focus on conventional immunosuppressive therapies, including glucocorticoids and immunosuppressive agents for Class III and IV lupus nephritis, with hydroxychloroquine as background therapy for all SLE patients with nephritis 5, 7
• The American Society of Nephrology recommends blockade of the renin-angiotensin system for patients with proteinuria ≥0.5g per 24 hours 5

Clinical Considerations and Future Directions

• Neutrophilic inflammation in certain conditions is predominantly driven by IL-17, with mixed results from clinical trials with anti-IL-17 agents in other inflammatory conditions 3, 4
• Further research is needed to determine if IL-17 levels could serve as a biomarker for disease activity, prediction of treatment response, and selection of patients who might benefit from IL-17-targeted therapies, with clinical trials specifically evaluating anti-IL-17 therapies in lupus nephritis warranted 5, 6, 7