TY - JOUR
T1 - Lupus nephritis – An update on disparities affecting african americans
AU - Portalatin, Gilda M.
AU - Gebreselassie, Surafel K.
AU - Bobart, Shane A.
N1 - Publisher Copyright:
© 2022 National Medical Association
PY - 2022/6
Y1 - 2022/6
N2 - Lupus Nephritis is a complex clinical manifestation of systemic lupus erythematosus (SLE) associated with significant morbidity and mortality. It disproportionately affects minorities, especially African Americans (AA) with higher rates of progression to end stage kidney disease. Several factors are implicated including genetic predisposition to both SLE and chronic kidney disease, social determinants of health such as income inequality, education disparities, social isolation/lack of support, health care access and affordability. Clinically, AA may have higher auto-antibody titers, including several antibodies occurring simultaneously. AA are more prone to severe disease such as Class III and IV lupus nephritis. Fortunately, clinical trials have shown a favorable benefit/response among African Americans to mycophenolate mofetil. However, newer and alternative agents such as Rituximab, Belimumab and Voclosporin are widely unaffordable, and AA remain underrepresented in these clinical trials. The current state of disparities affecting LN patients of AA ancestry is a call for better access to healthcare and social support systems, greater inclusion/representation in clinical trials, and making new and alternative regimens more affordable and cost effective.
AB - Lupus Nephritis is a complex clinical manifestation of systemic lupus erythematosus (SLE) associated with significant morbidity and mortality. It disproportionately affects minorities, especially African Americans (AA) with higher rates of progression to end stage kidney disease. Several factors are implicated including genetic predisposition to both SLE and chronic kidney disease, social determinants of health such as income inequality, education disparities, social isolation/lack of support, health care access and affordability. Clinically, AA may have higher auto-antibody titers, including several antibodies occurring simultaneously. AA are more prone to severe disease such as Class III and IV lupus nephritis. Fortunately, clinical trials have shown a favorable benefit/response among African Americans to mycophenolate mofetil. However, newer and alternative agents such as Rituximab, Belimumab and Voclosporin are widely unaffordable, and AA remain underrepresented in these clinical trials. The current state of disparities affecting LN patients of AA ancestry is a call for better access to healthcare and social support systems, greater inclusion/representation in clinical trials, and making new and alternative regimens more affordable and cost effective.
KW - African american
KW - Disparities
KW - Lupus nephritis
KW - Systemic lupus erythematosus
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U2 - 10.1016/j.jnma.2022.05.005
DO - 10.1016/j.jnma.2022.05.005
M3 - Review article
C2 - 35595581
AN - SCOPUS:85130315678
SN - 0027-9684
VL - 114
SP - S34-S42
JO - Journal of the National Medical Association
JF - Journal of the National Medical Association
IS - 3
ER -