1. The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide
- Author
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David D'Cruz, Daniel Abramovicz, Yair Levy, Gian Domenico Sebastiani, Frédéric Houssiau, Alberto Cauli, Rajko Popovic, Mauro Galeazzi, Geneviève Depresseux, Roberto Cattaneo, Peter Petera, Haner Direskeneli, Ricard Cervera, Carlos Vasconcelos, Radmila Petrovic, E. De Ramon Garrido, Ahmet Gül, Maria Giovanna Danieli, J Font, J-P Cosyns, Renato Alberto Sinico, Daniel Engelbert Blockmans, Houssiau, F, Vasconcelos, C, D'Cruz, D, Sebastiani, G, De Ramon Garrido, E, Danieli, M, Abramovicz, D, Blockmans, D, Cauli, A, Direskeneli, H, Galeazzi, M, Gül, A, Levy, Y, Petera, P, Popovic, R, Petrovic, R, Sinico, R, Cattaneo, R, Font, J, Depresseux, G, Cosyns, J, and Cervera, R
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Cyclophosphamide ,Immunology ,Lupus nephritis ,Urology ,Renal function ,Injections, Intravenou ,Kidney Function Tests ,General Biochemistry, Genetics and Molecular Biology ,Immunosuppressive Agent ,Young Adult ,chemistry.chemical_compound ,Rheumatology ,Azathioprine ,medicine ,Humans ,Immunology and Allergy ,Creatinine ,Kidney Function Test ,Biochemistry, Genetics and Molecular Biology (all) ,Proteinuria ,Dose-Response Relationship, Drug ,business.industry ,Lupus Nephriti ,Middle Aged ,medicine.disease ,Lupus Nephritis ,Surgery ,Regimen ,Treatment Outcome ,chemistry ,Epidemiologic Method ,Injections, Intravenous ,Drug Therapy, Combination ,Female ,medicine.symptom ,Epidemiologic Methods ,business ,Nephritis ,Immunosuppressive Agents ,Human ,medicine.drug ,Kidney disease - Abstract
Objective:To update the follow-up of the Euro-Lupus Nephritis Trial (ELNT), a randomised prospective trial comparing low-dose (LD) and high-dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment for proliferative lupus nephritis.Patients and methods:Data for survival and kidney function were prospectively collected during a 10-year period for the 90 patients randomised in the ELNT, except in 6 lost to follow-up.Results:Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (5/44 (11%) vs 2/46 (4%), 6/44 (14%) vs 5/46 (11%) and 2/44 (5%) vs 4/46 (9%), respectively) nor did mean serum creatinine, 24 h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. After 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy was confirmed.Conclusion:The data confirm that a LD IVCY regimen followed by AZA—the “Euro-Lupus regimen”—achieves good clinical results in the very long term.
- Published
- 2009
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