The Filtrate:Joel TopfSwapnil HiremathNayan AroraJennie LinJoshua WaitzmanSpecial GuestsAlfred Kim assistant Professor at Washington University, director of the lupus clinic. Receives support from Arena Pharmaceuticals, manufacturer of volcloosporin, or at least he did before this episode aired.Dawn Castor assistant professor at The University of Louisville School of Medicine. She is on the speaker bureau for Arena Pharmaceuticals, manufacturer of volcloosporin. She was a site principle investigator (PI) as well as an author of the trial.EditorNayan AroraShow Notes:NIH Cyclophosphamide trial, long term follow-up: Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis. Other important publications on this trial include:Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs NEJM 1986Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis Lancet 1992Euro-Lupus Nephritis Trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamideVoclosporin is approved by FDA in January 2021Previous Lupus Nephritis podcast with Dawn and Alfred: Freely Filtered 029: Belimumab for lupus nephritisRituximab în Lupus. The LUNAR Trial (Spoiler, it didn’t work): Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab studySystematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritisConclusion The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field.The ALMS trials of mycohenolate mofetil (MMF) trials in lupus nephritisInduction: Mycophenolate Mofetil versus Cyclophosphamide for Induction Treatment of Lupus Nephritis (JASN 2009)Maintenance: Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis (NEJM 2011)Jacob deGrom on the mound. Baseball Reference. DeGrom is a two time Cy Young award winner, a 4-time All-Star and former Rookie of the Year winner.AURORA2: Aurinia Renal Assessments 2: Aurinia Renal Response in Lupus With Voclosporin (ClinicalTrials.gov)Aurinia Pharmaceuticals.KDIGO 2021 Glomerulonephritis Guidelines Daily aspirin vs placebo for suspected acute myocardial infarction is highly protective except for patients born under Libra or Gemini. Current misconception 3: that subgroup-specific trial mortality results often provide a good basis for individualising patient careMultitarget therapy for induction treatment of lupus nephritis: a randomized trial.Patient Benefits Justify Price of New Lupus Nephritis Drugs“The estimated annual price of belimumab is approximately $43,000 per patient; the estimated annual price for voclosporin is approximately $92,000 per patient.”2019 update of the EULAR recommendations for the management of systemic lupus erythematosus GuidelineDr. Glaucomflecken on TwitterCardiology vs Nephrology Round 1Nephrology vs Cardiology Round 2In the Heights (Wikipedia)The Mitchells vs. the Machines (Wikipedia)Paws in PrisonFlozinator pin