Originally published by our sister publication Pain Medicine News
By Myles Starr
Published data indicate that for patients who have lupus, monitoring for kidney disease—even in the absence of pain—is important.
“In our study, most lupus patients with kidney disease did not have any other lupus symptoms and similarly did not report decreased quality of life,” said study author Philip M. Carlucci, MD, a resident physician at NYU Grossman School of Medicine, in New York City. “This suggests that lupus patients may not ‘feel’ potentially very serious disease in their kidneys, which reinforces the critically important need to regularly monitor for kidney involvement in these patients.”
Dr. Carlucci further noted that for patients who suffer from both kidney involvement and other symptoms such as lupus-related arthritis or rash, addressing only the kidney disease and not the other manifestations may not be sufficient for improving quality of life.
The study included 181 patients with lupus nephritis who completed a Patient-Reported Outcomes Measurement Information System 29-Item questionnaire at the time of a clinically indicated renal biopsy (Rheumatology [Oxford] 2024 Mar 26. doi:10.1093/rheumatology/keae189). Seventy-five (41%) patients had extrarenal disease (mean age, 34 years; 85% female) and 106 (59%) had isolated renal disease (mean age, 36 years; 82% female). Researchers reported rash (45%), arthritis (40%) and alopecia (40%) were the most common extrarenal manifestations.
They also found that compared with patients who had isolated renal disease, those with extrarenal disease reported significantly worse pain interference, less of an ability to participate in social roles, lower physical function and more fatigue.
Dr. Carlucci added that a newer immunosuppressive, belimumab (Benlysta, GSK), may be useful for selected patients with lupus nephritis who experience extrarenal manifestations.
“In addition, nonpharmacologic management should be pursued, when possible,” he continued. “For example, physical therapy/exercise is an excellent adjunctive treatment for those who can tolerate it. There is also some evidence for natural supplements such as curcumin (derived from turmeric) for decreasing inflammation in patients with lupus nephritis.”
A limitation of the study was that the researchers did not collect data as to which patients had fibromyalgia, which, according to Dr. Carlucci, is a common comorbidity in patients with lupus that is characterized by chronic pain.
To address this concern, the researchers are following lupus patients with fibromyalgia longitudinally to better understand how this might affect their experience with pain and how to better treat them.
Dr. Carlucci reported no relevant financial disclosures.
