Therapy of proliferative lupus glomerulonephritis: a prospective trial in The Netherlands.
Proliferative glomerulonephritis is a severe clinical manifestation of systemic lupus erythematosus, and it remains a major determinant of morbidity and mortality in this disease, despite the progress that has been made by treating patients with a combination of corticosteroids and cytotoxic drugs. Earlier controlled clinical trials have demonstrated the superior efficacy of a combination of pulse cyclophosphamide with steroids over treatment with steroids alone. However, cyclophosphamide carries a substantial risk of short-term and long-term toxicity in this predominantly young population, and previous trials have not convincingly shown any benefit over the milder treatment with a combination of azathioprine and steroids. We propose to conduct a Dutch multicentre trial to test whether similar renal survival can be achieved with an azathioprine-based regimen, compared to the widely used cyclophosphamide treatment, with a possibly lower risk of adverse effects.
Department of Nephrology, University Hospital, Leiden, Netherlands.
A W
AW
van den Wall Bake
J H
JH
Berden
R H
RH
Derksen
J W
JW
de Glas-Vos
E C
EC
Hagen
D001379:Azathioprine / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000401:mortality; D008775:Methylprednisolone / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D011241:Prednisone / Q000627:therapeutic use*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic
D003520:Cyclophosphamide; D001379:Azathioprine; D011241:Prednisone; D008775:Methylprednisolone