Outcomes in patients with active lupus nephritis requiring immunosuppressives who never received cyclophosphamide.
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.
Urowitz
Murray B
MB
University of Toronto Lupus Clinic, Toronto Western Hospital, Toronto, Ontario, Canada. m.urowitz@utoronto.ca
Ibañez
Dominique
D
Ali
Yaser
Y
Gladman
Dafna D
DD
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
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D001379:Azathioprine; D008727:Methotrexate