Treatment of Diffuse Proliferative Lupus Nephritis with Prednisone and Combined Prednisone and Cyclophosphamide
- 23 November 1978
- journal article
- research article
- Published by Massachusetts Medical Society in The New England Journal of Medicine
- Vol. 299 (21), 1151-1155
- https://doi.org/10.1056/nejm197811232992102
Abstract
To evaluate the effectiveness of cyclophosphamide in the treatment of lupus nephritis, we designed a prospective study of patients with diffuse proliferative lupus nephritis. Twenty-six patients received prednisone (average dose, 40 mg per day) and 24 combined prednisone (average dose, 29 mg per day) and cyclophosphamide (average dose, 107 mg per day) for six months. Thereafter, all patients received maintenance doses of prednisone. Most of the patients improved (84 per cent) after six months of initial treatment with either program. Early progression of disease, ending mainly in end-stage renal disease, was equally frequent in, the two treatment groups in patients with already advanced disease. In a four-year follow-up study there was a higher incidence (P≈0.04) and average rate (P≈0.02) of clinical recurrence of nephritis in the group initially given only steroid than in the group initially given both drugs. However, the proportion of patients alive after four years with stable or improved renal function was similar in the two treatment groups. (N Engl J Med 299:1151–1155, 1978)Keywords
This publication has 10 references indexed in Scilit:
- Detection of circulating immune complexes in patients with glomerulonephritisKidney International, 1977
- Lupus nephritis: Clinical course as related to morphologic forms and their transitionsThe American Journal of Medicine, 1977
- Avidity of anti-DNA antibodies in serum and IgG glomerular eluates from patients with systemic lupus erythematosus. Association of high avidity antinative DNA antibody with glomerulonephritis.JCI Insight, 1977
- Immune potential in human uraemia. 1. Relationship of glomerular filtration rate to depression of immune potential.Journal of Clinical Pathology, 1976
- The bimodal mortality pattern of systemic lupus erythematosusThe American Journal of Medicine, 1976
- Cyclophosphamide or Azathioprine in Lupus GlomerulonephritisAnnals of Internal Medicine, 1975
- Further observations on the treatment of lupus nephritis with prednisone and combined prednisone and azathioprineArthritis & Rheumatism, 1974
- The Effect of Treatment with Prednisone and Nitrogen Mustard on the Renal Lesions and Life Span of Patients with Lupus GlomerulonephritisNephron, 1973
- Criteria for the classification of systemic lupus erythematosus—status 1972Arthritis & Rheumatism, 1972
- THE FIRST COMPONENT OF THE KININ-FORMING SYSTEM IN HUMAN AND RABBIT PLASMAThe Journal of Experimental Medicine, 1971