Urinary mRNA and lupus disease flare
Systemic lupus erythematosus (SLE) is a life‐threatening systemic autoimmune disease. Lupus nephritis is one of the most severe manifestations of SLE and occurs in around half of all lupus patients.1 In the past two decades, many new therapeutic options, including mycophenolate, calcineurin inhibitors and biological agents that target key pathogenic mechanisms of lupus nephritis, became available.2 In general, the clinical outcome of lupus nephritis has improved substantially with these therapeutic advances. Nonetheless, a considerable proportion of patients remain refractory to treatment. Published studies reported that with the state‐of‐the‐art immunosuppressive and supportive therapy, the 6–12 month complete remission rates of proliferative lupus nephritis are 8–30%, respectively, and additional partial response rates between 20% and 50%.3
The most important clinical problem of SLE is, however, not the induction of remission. SLE typically runs a remission and relapsing course. Previous study showed that SLE had around 20–30% chance of flare per patient‐year of follow‐up.5 Although many of the flares are mild, recurrent SLE flares may result in irreversible kidney damage and dialysis‐dependent renal failure.