{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:11:27Z","timestamp":1778155887472,"version":"3.51.4"},"reference-count":63,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Lupus nephritis (LN), a major complication of systemic lupus erythematosus, remains a key determinant of morbidity and mortality despite therapeutic progress. Objective: An expert report aims to present multidisciplinary insights from leading Italian centers on current LN management and future perspectives. Methods: Seven specialists\u2014including nephrologists and rheumatologists with expertise in lupus nephritis\u2014addressed key aspects of LN management, including treatment goals, available therapeutic options, treatment selection across disease stages, and emerging strategies. Results: The authors highlight evolving treatment paradigms\u2014shifting from traditional induction\u2013maintenance strategies to early combination regimens integrating biologics such as belimumab and calcineurin inhibitors like voclosporin\u2014aligned with updated EULAR and KDIGO guidelines. Regional experiences underscore individualized therapy tailored by histology, disease activity, and patient profile. Multidisciplinary collaboration between nephrologists and rheumatologists, equitable access to innovative therapies, and integration of registries and digital records are identified as priorities. Conclusions: Emerging agents, including obinutuzumab, anifrolumab, and CAR-T cell therapies, represent promising advances toward steroid-sparing and potentially curative strategies. Continued research, biomarker development, and application of artificial intelligence are pivotal to optimizing outcomes and achieving personalized LN management.<\/jats:p>","DOI":"10.3390\/jcm15103570","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T10:39:47Z","timestamp":1778150387000},"page":"3570","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advancing Care in Lupus Nephritis: Expert Perspectives on Current Practices and Future Directions in Italy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-4983","authenticated-orcid":false,"given":"Andrea","family":"Doria","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Medicine (DIMED), University of Padua, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3678-6124","authenticated-orcid":false,"given":"Franco","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, ERN ReCONNET Center, ASST Spedali Civili, University of Brescia, 25121 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loreto","family":"Gesualdo","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Moroni","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy"},{"name":"Nephrology and Dialysis Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Mosca","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9470-218X","authenticated-orcid":false,"given":"Renato Alberto","family":"Sinico","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4419-6813","authenticated-orcid":false,"given":"Dario","family":"Roccatello","sequence":"additional","affiliation":[{"name":"University Center of Excellence on Nephrology, Rheumatology and Rare Diseases, Nephrology and Dialysis Unit-CMID, ERKnet, ERNReCONNET and RITA-ERN, S. Giovanni Bosco Hospital, University of Turin, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1093\/rheumatology\/kev311","article-title":"The Frequency and Outcome of Lupus Nephritis: Results from an International Inception Cohort Study","volume":"55","author":"Hanly","year":"2016","journal-title":"Rheumatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s40744-021-00368-y","article-title":"The Economic Burden of Lupus Nephritis: A Systematic Literature Review","volume":"9","author":"Thompson","year":"2022","journal-title":"Rheumatol. 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