Asymptomatic serologic reactivation in patients with lupus nephritis in clinical remission: to treat or not to treat?

The authors examine whether preemptively increasing immunosuppression is more effective than watchful monitoring in patients with lupus nephritis who exhibit asymptomatic serologic reactivation, specifically a rise in anti-double-stranded DNA antibodies. They discuss the findings of a randomized trial by Yap et al. in the context of current treatment strategies and the evolving therapeutic landscape for managing lupus nephritis. The central question is whether proactive treatment is warranted in these patients to prevent potential flares.