title: Randomized controlled trial of pulse/synchronization cyclophosphamide/apheresis for proliferative lupus nephritis.
abstract: 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.
  
  
  CONCLUSIONS
  The addition of pulse/synchronization apheresis to cyclophosphamide therapy does not improve the course of patients with proliferative lupus nephritis.
authors.affiliation: Department of Medicine and Pathology and Laboratory Medicine, Cedars-Sinai/UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Wallace
authors.forename: D
authors.initials: D
authors.lastname: Goldfinger
authors.forename: S H
authors.initials: SH
authors.lastname: Pepkowitz
authors.forename: M
authors.initials: M
authors.lastname: Fichman
authors.forename: A L
authors.initials: AL
authors.lastname: Metzger
authors.forename: J O
authors.initials: JO
authors.lastname: Schroeder
authors.forename: H H
authors.initials: HH
authors.lastname: Euler
mesh_terms: D000328:Adult; D001781:Blood Component Removal / Q000379:methods*; D002455:Cell Division / Q000187:drug effects; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008181:Lupus Nephritis / Q000628:therapy*
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide