Lupus nephritis: a review of the current pharmacological treatments.
Proliferative lupus glomerulonephritis World Health Organization Class III and IV patients should benefit from an induction and maintenance therapy with a combined immunosuppressive treatment. Cyclophosphamide is the main recommended drug in induction therapy for a 3- to 6-month treatment period. Refractory lupus nephritis may be considered for immunoablative cyclophosphamide treatment with or without haematopoietic CD34(+) stem-cell transplantation or rituximab. Maintenance therapy should contain either quarterly cyclophosphamide pulses, azathioprine or mycophenolate mofetil for a total treatment duration of at least 2 years. Recent studies suggested a similar efficacy of mycophenolate mofetil and cyclophosphamide in induction and maintenance therapy. This result has to be confirmed in long-term studies.
Mercadal
Lucile
L
Pitié-Salpêtrière Hospital, Nephrology Department, 83 bd de l hopital, 75013 Paris, France. lucile.mercadal@psl.ap-hop-paris.fr
Deray
Gilbert
G
D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008181:Lupus Nephritis / Q000150:complications / Q000188:drug therapy*
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide