Feb. 09, 2012

Latest “Royal Pains” Episode Highlights Lupus Nephritis

During the February 8, 2012 episode of the USA Network show, Royal Pains, the character of Jack O'Malley is not following his doctor’s directions for treatment of lupus-related kidney disease, called lupus nephritis. 

While males and females with lupus share similar features of the disease, men are believed to develop lupus nephritis more frequently than women.  Lupus nephritis is a serious and potentially fatal complication of lupus caused by inflammation in the kidneys, making them unable to properly remove waste from the blood or control the amount of fluids in the body.   Left untreated, nephritis can lead to permanent damage to the kidneys and possibly end-stage renal disease (ESRD) and kidney failure.

Symptoms of nephritis not readily apparent

In the early stages of lupus nephritis, there are very few signs that anything is wrong.  One problem with lupus-related kidney disease, as with the case of most kidney disorders, is that a person cannot directly sense a problem with the kidneys until a significant amount of his/her renal (kidney) function is gone. For example, most patients with kidney disease do not experience any symptoms until 70-75% of renal function is gone.  While a patient might feel well, there can be significant and life-threatening damage underway in the kidneys.  A patient may dismiss the seriousness of the disease because they don’t sense pain.  The progression of lupus is unpredictable.  Lupus can present itself in many ways, come and go, and vary in intensity over time.

Follow doctor’s orders

It is extremely important that an individual who may have lupus – especially if the kidneys or another vital organ are involved – seek care from a medical specialist who is experienced in treating lupus and follow the doctors’ directives precisely.  Lupus nephritis cases usually are managed by a nephrologist, a doctor who specializes in diseases of the renal system.  It is important to note that while lupus nephritis is serious, treatments are available.   With early diagnosis and treatment, most cases are manageable.  However, delayed or inadequate treatment can put the person at risk for serious and life-threatening complications.

Background medications provided during lupus clinical trials

During an earlier episode, Jack was offered the opportunity to participate in a lupus clinical trial.  Concern was raised that he might receive a ‘placebo’ rather than the experimental drug.  It was implied that that if Jack received a placebo he would not receive any treatment.  Please note that this is not an accurate portrayal of lupus nephritis clinical trials. 

Clinical trials are studies that evaluate the safety and effectiveness of new drugs or treatment strategies. In order to conduct valid studies, volunteers usually are divided into several treatment groups.  Each group receives a different treatment so investigators can compare effectiveness.  One group is designated to receive a ‘placebo.’

The term ‘placebo’ in lupus nephritis clinical trials is misleading.  Because lupus can be serious and life-threatening, all participants continue to receive appropriate background therapies, or standard care.  The experimental medication is administered in addition to the standard care therapy so all study participants continue to receive treatment.

The Lupus Foundation of America’s Center for Clinical Trials Education Web site has additional information about participating in a lupus clinical trial.

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