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Controlled studies of oral immunosuppressive drugs in lupus nephritis. A long-term follow-up.
- Source :
-
Annals of internal medicine [Ann Intern Med] 1983 Jul; Vol. 99 (1), pp. 1-8. - Publication Year :
- 1983
-
Abstract
- From 1969 to 1975, 53 patients with lupus nephritis took part in randomized trials comparing prednisone, oral azathioprine plus low-dose prednisone, and oral cyclophosphamide plus low-dose prednisone. After a mean follow-up of 85 months, cyclophosphamide appears marginally superior to prednisone for maintaining renal function (p = 0.03) and preventing end-stage renal failure (p = 0.07). Chronic change shown by renal biopsy assessed by a chronicity index was found useful in predicting renal function outcomes and response to immunosuppressive therapy. Three of 21 patients with a low chronicity index and 9 of 10 patients with a high chronicity index doubled their serum creatinine (p less than 0.00003). The probability of renal functional deterioration was not different among the treatments studied. However, in 14 patients with an intermediate chronicity index, 1 of 11 patients treated with azathioprine or cyclophosphamide doubled the serum creatinine level whereas all 3 patients treated with prednisone have progressed to end-stage renal failure (p = 0.005). The study suggests that single-drug oral immunosuppressive treatment combined with prednisone is most beneficial in lupus patients with intermediate chronic change shown by renal biopsy.
- Subjects :
- Administration, Oral
Adolescent
Adult
Azathioprine therapeutic use
Child
Clinical Trials as Topic
Cyclophosphamide therapeutic use
Female
Follow-Up Studies
Glomerulonephritis etiology
Glomerulonephritis pathology
Humans
Immunosuppressive Agents adverse effects
Lupus Erythematosus, Systemic complications
Male
Middle Aged
Prednisone therapeutic use
Random Allocation
Glomerulonephritis drug therapy
Immunosuppressive Agents therapeutic use
Lupus Erythematosus, Systemic drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0003-4819
- Volume :
- 99
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 6344715
- Full Text :
- https://doi.org/10.7326/0003-4819-99-1-1