title: Clinical Predictors of Response to Prednisone Plus Cyclophosphamide in Patients with Idiopathic Membranous Nephropathy.
abstract: BACKGROUND
  Complete remission (CR) and partial remission (PR) are beneficial to the long-term outcome of patients with idiopathic membranous nephropathy (iMN). However, we are lacking in studies that evaluate the clinical predictors of response to treatment with prednisone plus cyclophosphamide (CP). The objectives of the study are to identify clinical factors that could predict clinical remission or relapse in patients with iMN who were treated with prednisone plus i.v. CP therapy.
  
  
  METHODS
  This retrospective study recruited a total of 102 eligible patients diagnosed with biopsy-proven iMN between January 2010 and December 2013 in our center. All subjects were treated with prednisone plus i.v. CP for at least 6 months. Primary outcome was remission, including both CR and PR. Demographic data and clinical data at baseline and month 3 of treatment with CP were assessed.
  
  
  RESULTS
  The proportion of patients with remission (both CR and PR) was 82.4%, over an average follow-up duration of 15 (10-27.5) months. Fifty-two of them experienced a CR. Baseline proteinuria and the reduction of proteinuria at month 3 of CP treatment were independent predictors of remission (p < 0.05) and CR (p < 0.05). In addition, the presence of a PR versus a CR was associated with the risk of relapse (hazards ratio 21.521, 95% CI 4.534-102.150, p < 0.001).
  
  
  CONCLUSIONS
  Patients with low proteinuria at baseline and high reduction of proteinuria at month 3 of treatment with CP were more likely to achieve remission and CR. The presence of only a PR may act as a useful predictor of relapse after completion of CP therapy.
authors.affiliation: Department of Nephrology, Molecular Cell Lab for Kidney Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Li
authors.forename: Ling
authors.initials: L
authors.lastname: Wang
authors.forename: Minfang
authors.initials: M
authors.lastname: Zhang
authors.forename: Wenyan
authors.initials: W
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.forename: Chaojun
authors.initials: C
authors.lastname: Qi
authors.forename: Shan
authors.initials: S
authors.lastname: Mou
authors.forename: Xinghua
authors.initials: X
authors.lastname: Shao
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Ni
mesh_terms: D000328:Adult; D000368:Aged; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D011507:Proteinuria / Q000188:drug therapy; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011241:Prednisone