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Randomized controlled trial of pulse/synchronization cyclophosphamide/apheresis for proliferative lupus nephritis

✍ Scribed by Daniel J. Wallace; Dennis Goldfinger; Samuel H. Pepkowitz; Marshal Fichman; Allan L. Metzger; Johann O. Schroeder; Hans H. Euler

Publisher: John Wiley and Sons
Year: 1998
Tongue: English
Weight: 39 KB
Volume: 13
Category: Article
ISSN: 0733-2459
DOI: 10.1002/(sici)1098-1101(1998)13:4<163::aid-jca4>3.0.co;2-1

No coin nor oath required. For personal study only.

✦ Synopsis

OBJECTIVE: To assess the efficacy of pulse/synchronization cyclophosphamide/apheresis in patients with proliferative lupus nephritis. METHODS: Eighteen patients with Class III or IV renal biopsies and chronicity indices <6 were prospectively randomized to receive 6 courses of parenteral cyclophosphamide over 8 months along with prednisone. Nine of these patients also received 3 daily plasmaphereses prior to each of the 6 courses of cyclophosphamide. Assessments compiled at 6 and 24 months included serum creatinine, albumin, anti DNA, 24-hour urine protein, and C3 complement along with SLAM scores. RESULTS: Two out of nine patients in each group evolved end stage renal disease and 3/9 patients in each group went into a renal remission at 24 months. Serum albumin, C3 complement, and SLAM scores improved in both groups, and anti-DNA improved in the pulse/ synchronization patients (P < 0.025). No intergroup comparisons were significant. CONCLUSION: The addition of pulse/synchronization apheresis to cyclophosphamide therapy does not improve the course of patients with proliferative lupus nephritis.

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