title: Outcomes in patients with active lupus nephritis requiring immunosuppressives who never received cyclophosphamide.
abstract: OBJECTIVE
  To assess outcomes in patients with lupus nephritis treated with immunosuppressives compared to those treated with cyclophosphamide in a cohort study and in a matched cohort study.
  
  
  METHODS
  Patients with active renal disease treated with immunosuppressive/cytotoxic medications were selected from the University of Toronto Lupus Clinic database. Five outcomes were evaluated: all-cause mortality, renal failure, reversal of active renal disease, relapse of active renal disease, and toxicity.
  
  
  RESULTS
  There were no differences in the outcomes of death, renal failure, reversal or relapse of active renal disease, or toxicity in those using or not using cyclophosphamide.
  
  
  CONCLUSIONS
  Antimetabolites should be considered standard of care for patients with lupus nephritis both for induction and for maintenance therapy.
authors.affiliation: University of Toronto Lupus Clinic, Toronto Western Hospital, Toronto, Ontario, Canada. m.urowitz@utoronto.ca
authors.forename: Murray B
authors.initials: MB
authors.lastname: Urowitz
authors.forename: Dominique
authors.initials: D
authors.lastname: Ibañez
authors.forename: Yaser
authors.initials: Y
authors.lastname: Ali
authors.forename: Dafna D
authors.initials: DD
authors.lastname: Gladman
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use*; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011379:Prognosis; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D001379:Azathioprine; D008727:Methotrexate