Cyclophosphamide or azathioprine in lupus glomerulonephritis. A controlled trial: results at 28 months.
Thirty-eight patients with diffuse glomerulonephritis of systemic lupus erythematosus were randomly assigned to add cyclophosphamide, azathioprine, or nothing to low-dose corticosteroid treatment and have been followed for a mean of 21/3 years thereafter. Of the 11 patients with unfavorable outcomes (8 deaths and 2 beginning hemodialyses), 2 occurred on cyclophosphamide, 4 on azathioprine, and 5 on prednisone only. Deaths due to infection occurred on the cytotoxics, while deaths ascribed to central nervous system lupus erythematosus occurred exclusively on prednisone only. Gradual deterioration of renal function was observed in all three groups, most frequently on prednisone only. Undesirable events, some due to drugs, were observed. At the time of reporting, the cytotoxic agents seemed to add marginally to the control of the disease; other treatment schedules should be evaluated.
D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002986:Clinical Trials as Topic; D003176:Complement C3 / Q000032:analysis; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003556:Cystitis / Q000139:chemically induced; D004342:Drug Hypersensitivity / Q000209:etiology; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000401:mortality; D006417:Hematuria / Q000188:drug therapy; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000401:mortality; D011020:Pneumonia, Pneumocystis / Q000401:mortality; D011241:Prednisone / Q000627:therapeutic use; D011507:Proteinuria / Q000188:drug therapy; D006435:Renal Dialysis
D003176:Complement C3; D003520:Cyclophosphamide; D001379:Azathioprine; D011241:Prednisone