[Proliferative lupus nephritis treatment: practice survey in nephrology and internal medicine in France].
European and American recommendations have recently been published for the treatment of proliferative lupus nephritis (LN). This study aimed to describe current practice in France. An electronic survey was sent to French nephrologists and internists via their scientific society between March and December 2012. One hundred and nine specialists (60 internists, 48 nephrologists and 1 rheumatologist), mostly from hospitals, completed the survey. Low-dose cyclophosphamide (Euro-Lupus) was the first induction immunosuppressive therapy used (67%), followed by mycophenolate mofetil (MMF) (20%) and high dose CYC (NIH, 9%). Maintenance immunosuppressive therapy after an induction with CYC was preferentially MMF (58%), versus 14% for azathioprine (AZA) and 25% using either MMF or AZA without preference. After an induction with MMF, maintenance treatment was mainly MMF (77%). Antimalarial drugs were prescribed systematically by 86% of specialists. In patients in stable remission, maintenance treatment was withdrawn after 2 years (40%), 3 years (25%) or more (34%). Low-dose corticosteroids were continued in the long-term by 54% of specialists. No difference was observed between nephrologists and internists, even in the prescription of antimalarials. Treatment of proliferative LN in France is homogenous enough and is consistent with recent international recommendations.
Service de néphrologie, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France. Electronic address: noemie.jourde@ap-hm.fr.
Noémie
N
Jourde-Chiche
Service de médecine interne, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France.
Laurent
L
Chiche
Service de santé publique, Aix-Marseille université, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
Julien
J
Mancini
Service d'anatomie pathologique, Aix-Marseille université, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
Laurent
L
Daniel
Laboratoire d'immunologie, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France.
Nathalie
N
Bardin
Service de néphrologie, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France.
Stéphane
S
Burtey
Service de néphrologie, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France.
Bertrand
B
Gondouin
Service de néphrologie, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France.
Bertrand
B
Dussol
Service de médecine interne, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille cedex 5, France.
Jean-Robert
JR
Harlé
Service de médecine interne, hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
Mohamed
M
Hamidou
Service de néphrologie, centre hospitalier Henri-Duffaut, 305, rue Raoul-Follereau, 84000 Avignon, France.
Quentin
Q
Meulders
Service de néphrologie, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris, France.
Eric
E
Daugas
D001379:Azathioprine / Q000627:therapeutic use; D005602:France; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007388:Internal Medicine; D008181:Lupus Nephritis / Q000188:drug therapy*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009398:Nephrology; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine
Enquête de pratique; Induction treatment lupus nephritis; Maintenance treatment; Néphropathie lupique; Survey; Traitement d’entretien; Traitement d’induction