2026 Update: What to Do When Lupus Nephritis Biologics Fail

Traditional protocols aren't enough when kidneys are at stake. Learn to identify the pivot point from standard care to advanced biologic intervention. Complete the activity and claim your CME/AAPA credit here: https://bit.ly/4cE1Pyw View the slide deck: 0:00 – Introduction 1:02 – Lupus nephritis: scope of the problem 2:05 - Case 1: Ms. KG 6:10 – ISN/RPS LN classification system 7:24 – Activity and chronicity indices for LN 8:04 – Impact of LN 9:34 – ACR guidelines for the treatment of LN 14:07 – Case 1: Ms. KG continued 15:04 – AURORA 1: Voclosporin vs placebo for LN 18:09 – BLISS-LN: Belimumab vs placebo for LN 20:35 – NOBILITY: Obinutuzumab vs placebo for LN (Phase 2) 21:42 – REGENCY: Obinutuzumab vs placebo for LN (Phase 3) 22:20 -Case 1: Ms. KG continued 27:25 – Case 2: Mr. SV 34:05 – Case 3: Ms. CP 37:55 – Therapeutic decision-making algorithm 38:58 – Challenges to incorporating new therapies for treatment of LN 39:58 – Case 3: Ms. CP continued 47:34 – Evidence for the importance of repeat biopsy 48:07 -Case 3: Ms. CP continued 48:56 - Key Takeaways Follow us here: Facebook   / i3health   Instagram   / i3health   Soundcloud   / i3-health   X   / i3health   STATEMENT OF NEED Lupus nephritis is a severe complication that develops in up to 60% of individuals with systemic lupus erythematosus (SLE). Characterized by kidney inflammation and chronic parenchymal damage, lupus nephritis leads to progressive kidney damage and potential kidney failure, representing one of the leading causes of morbidity and mortality among patients with SLE. The emergence of novel biological agents and combination therapies has provided a promising new approach to the treatment of lupus nephritis. This Clinical Case Conference will explore 3 complex case studies illustrating the use of novel therapies and combinations in the management of lupus nephritis (Wiegley et al, 2024). It features perspectives from Anca Askanase, MD, Professor of Medicine, Director of the Lupus Center, and Director of Rheumatology Clinical Trials at Columbia University Irving Medical Center; Andrew Bomback, MD, MPH, Associate Professor of Medicine and Co-Director of the Center for Glomerular Diseases at Columbia University Irving Medical Center; and Samir Parikh, MD, Clinical Professor of Internal Medicine in the Division of Nephrology at The Ohio State University Wexner Medical Center. DISCLOSURE OF RELEVANT FINANCIAL INFORMATION WITH INELIGIBLE COMPANIES i3 Health endorses the standards of the ACCME that require everyone in a position to control the content of a CME activity to disclose all financial relationships with ineligible companies that are related to the content of the CME activity. CME activities must be balanced, independent of commercial bias, and promote improvements or quality in healthcare. All recommendations involving clinical medicine must be based on evidence accepted within the medical profession. Relevant financial relationships exist between the following individuals and ineligible companies: Anca Askanase, MD, discloses that she has served as a consultant for AbbVie, Amgen, AstraZeneca, Aurinia, Biogen, Bristol Myers Squibb, Cabaletta, Celgene, Eli Lilly, Idorsia, Janssen, Genentech, GlaxoSmithKline, Mallinckrodt, Nkarta, Pfizer, Sana, Sanofi, Thermo Fisher, and UCB; and that she has received grants/research support from Nkarta. Andrew Bomback, MD, MPH, discloses that he has served on an advisory board or panel for GlaxoSmithKline; that he has served on a speaker's bureau for Otsuka; and that he has served as a consultant for Amgen, Apellis, Aurinia, Novartis, and Travere. Samir Parikh, MD, discloses that he has served on an advisory board or panel for Alexion, Calliditas, GlaxoSmithKline, Travere, Vera, and Vertex; that he has served as a consultant for Alexion, Aurinia, Calliditas, GlaxoSmithKline, Kezar, Travere, Vera, and Vertex; and that he has received grants/research support from Aurinia. COMMERCIAL SUPPORT This activity is supported by an educational grant from Genentech, a member of the Roche Group. #lupusnephritis #sle ##nephrology #rheumatology #kidneyhealth #lupusresearch #lupustreatment #ClinicalCaseConference #medicaleducation #internalmedicine #kidneydisease #autoimmunedisease #physicians #cme #meded #news #medical #kidney #lupus #medicalresearch #meded #lupuscommunity #patientadvocacy #cancercare #healthcare #medicine #science #learnonyoutube #doctor #premed #trending #educational #didyouknow #mindblown #inspiration #knowledge #lupussupport