Table 1.

Guidelines for immunosuppressive treatment of pure membranous lupus nephritis in adults.

Guideline OrganizationPublication Yr LocationInductionTreat Non-nephrotic ProteinuriaMaintenance
ACR92012USAMMF + oral GC.Not addressedMMF or AZA
Alt: CYC + GC pulse followed by oral GC
ALNN122013AsiaGC + MMF, AZA, MMF, or CNIYes, if deteriorating renal function or “active serology”Not addressed
EULAR/ERA-EDTA82012EuropeMMF + oral GC.Not addressedMMF + oral GC.
Alt: CYC, CNI, RTXAlt: AZA, CNI
GEAS112012SpainOral GC + CYC, CNI, MMF, or AZANo distinction for non-nephrotic range proteinuriaOral GC + MMF, CNI, or AZA
KDIGO102012InternationalGC + CYC, CNI, MMF, or AZAAs dictated by extrarenal manifestationNot addressed
  • ACR: American College of Rheumatology; ALNN: Asian Lupus Nephritis Network; EULAR/ERA-EDTA: European League Against Rheumatism/European Renal Association–European Dialysis and Transplant Association; GEAS: Systemic Autoimmune Disease Working Group of the Spanish Society of Internal Medicine and Spanish Society of Nephrology; KDIGO: Kidney Disease: Improving Global Outcomes; MMF: mycophenolate; GC: glucocorticoid (oral, prednisone; pulse, methylprednisolone); Alt: alternative; CYC: cyclophosphamide; AZA: azathioprine; CNI: calcineurin inhibitors; RTX: rituximab.