TABLE 2.
A summary of drugs for SLE hypertension/lupus nephritis.
| Medication class | Example drug | Target/Mechanism of action | References |
|---|---|---|---|
| Antimalarial | Hydroxychloroquine | Lysosomes, double-stranded DNA; inhibits immune activation and production of proinflammatory cytokines | Schrezenmeier and Dörner, (2020) |
| Corticosteroids | Methylprednisolone | Glucocorticoid receptors; inhibit many inflammation-associated molecules such as cytokines, chemokines, arachidonic acid metabolites, and adhesion molecules | Ocejo and Correa, (2021) |
| B cell inhibitors | Rituximab | CD20 on B cells; depletes B cell activity | de Bourcy et al. (2017) |
| Mycophenolate mofetil | Inhibits B cell activation and plasma cell synthesis | Eickenberg et al. (2012) | |
| Cyclophosphamide | Inhibits B cell activation and plasma cell synthesis | Eickenberg et al. (2012) | |
| Belimumab | B lymphocyte stimulator inhibitor; inhibits B lymphocyte proliferation and differentiation into plasma cells, induces apoptosis of autoreactive B cells | Chugh and Kalra, (2013) | |
| Type-I IFN inhibitor | Anifrolumab-fnia | Type I IFN Receptors; binds to IFNAR1, blocking action of all Type I IFNs, inhibiting downstream inflammatory and immunological processes | Tanaka and Tummala, (2021) |
| PPAR-γ agonist | Rosiglitazone | Adipose tissue; reduces ET-1, lowers blood pressure, reduces renal inflammation and injury | Venegas-Pont et al. (2009) |
| Protease inhibitor | Bortezomib | Chymotrypsin-like subunit of 26S proteasome; decreases production of autoantibodies and attenuates hypertension | Segarra et al. (2020) |
| Immunosuppressa-nts | Azathioprine | Incorporates into DNA and RNA to inhibit their synthesis, inhibits CD28-mediated signal in T cells | Fava and Petri, (2019) |
| Methotrexate | Dihydrofolate reductase; interferes with DNA synthesis, repair, and replication, reducing purine synthesis, depletes folates | Fava and Petri, (2019) | |
| Calcineurin inhibitor | Voclosporin | Binds and inhibits calcineurin, suppressing T cell activation and reducing renal inflammation | Rovin et al. (2021) |
Table 2 DNA—deoxyribonucleic acid; RNA—-ribonucleic acid; IFN—interferon; IFNAR1—subunit one of the type 1 interferon receptor; PPARγ—peroxisome proliferator activator receptor-gamma; ET-1—Endothelin-1.