Lupus nephritis: a review of the current pharmacological treatments

Lucile Mercadal1, Gilbert Deray

  • 1Pitié-Salpêtrière Hospital, Nephrology Department, 83 bd de l hopital, 75013 Paris, France. lucile.mercadal@psl.ap-hop-paris.fr

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.

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