{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:31:10Z","timestamp":1786480270654,"version":"build-2736575974"},"reference-count":67,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>SLE is a chronic multisystem autoimmune disease that affects the kidneys in approximately 50% of patients, with the prevalence rising to as high as 70% in certain populations, such as African American and Asian people. Antimalarials\u2014and particularly hydroxychloroquine (HCQ)\u2014are currently considered a mainstay of therapy, together with immunosuppressants. Over the past decades, several studies have extensively investigated the mechanisms of action of antimalarial agents and their potential beneficial properties in patients with SLE in general. However, the evidence for the therapeutic benefit of HCQ in patients with lupus nephritis (LN) derives mainly from observational studies, conducted in an era before the refinement of induction and maintenance protocols for immunosuppressive therapy. Despite the paucity of high-quality evidence on its efficacy in LN, the nephrology community widely supports the universal use of HCQ in patients with LN, and recommendations for its use are firmly entrenched in various clinical practice guidelines. Nonetheless, the use of antimalarials may also carry inherent risks, underscoring the importance of personalized approaches in these patients. Herein, we comprehensively review the available literature on antimalarials in LN, aiming to update the current evidence, limitations, and future perspectives for the use of antimalarials in adults.<\/jats:p>","DOI":"10.34067\/kid.0000000626","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T12:01:50Z","timestamp":1729512110000},"page":"1938-1947","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Antimalarials in Lupus Nephritis"],"prefix":"10.34067","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5830-9663","authenticated-orcid":false,"given":"Fernando","family":"Caravaca-Font\u00e1n","sequence":"first","affiliation":[{"name":"Department of Nephrology, Instituto de Investigaci\u00f3n Hospital \u201c12 de Octubre\u201d (imas12), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8374-9508","authenticated-orcid":false,"given":"Federico","family":"Yandian","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital de Cl\u00ednicas \u201cDr. Manuel Quintela\u201d, Montevideo, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5812-9809","authenticated-orcid":false,"given":"Ladan","family":"Zand","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4536-7709","authenticated-orcid":false,"given":"Sanjeev","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9952-209X","authenticated-orcid":false,"given":"Fernando C.","family":"Fervenza","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"issue":"2","key":"B1-20250823","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1053\/j.ajkd.2019.10.017","article-title":"Update on lupus nephritis: core curriculum 2020","volume":"76","author":"Parikh","year":"2020","journal-title":"Am J Kidney Dis."},{"issue":"1","key":"B2-20250823","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1038\/s41572-019-0141-9","article-title":"Lupus nephritis","volume":"6","author":"Anders","year":"2020","journal-title":"Nat Rev Dis 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concentration in lupus nephritis: a determinant of disease outcome?","volume":"33","author":"Cunha","year":"2018","journal-title":"Nephrol Dial Transplant."},{"issue":"11","key":"B7-20250823","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.3899\/jrheum.150379","article-title":"Hydroxychloroquine blood levels in systemic lupus erythematosus: clarifying dosing controversies and improving adherence","volume":"42","author":"Durcan","year":"2015","journal-title":"J Rheumatol."},{"issue":"3","key":"B8-20250823","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1080\/14740338.2017.1269168","article-title":"Hydroxychloroquine in systemic lupus erythematosus (SLE)","volume":"16","author":"Ponticelli","year":"2017","journal-title":"Expert Opin Drug Saf."},{"issue":"8","key":"B9-20250823","doi-asserted-by":"crossref","first-page":"4794","DOI":"10.4049\/jimmunol.1000702","article-title":"Mechanism of endosomal TLR inhibition by antimalarial drugs and 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Potential biases in observational studies of drug effects: Comment on the article by Pons-Estel et al","volume":"61","author":"Vinet","year":"2009","journal-title":"Arthritis Rheum."},{"issue":"5","key":"B52-20250823","doi-asserted-by":"crossref","first-page":"e75","DOI":"10.1136\/annrheumdis-2020-217728","article-title":"Hydroxychloroquine is neutral in risk of chronic kidney disease in patients with systemic lupus erythematosus","volume":"81","author":"Wu","year":"2022","journal-title":"Ann Rheum Dis."},{"issue":"3","key":"B53-20250823","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/imj.15908","article-title":"How toxic is an old friend? 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