Current concepts in immunosuppressive drug therapy of systemic lupus erythematosus

The routine use of intravenous cyclophosphamide has led to advances in the preservation of renal function and quality of life for patients with systemic lupus erythematosus complicated by diffuse proliferative glomerulonephritis. Most patients receiving 3 years of intravenous cyclophosphamide according to a rigorous protocol experience longterm remission of their disease. However, in some the disease continues to progress or flares recurrently. Early intervention and combined immunosuppressive regimens modeled on protocols developed for the treatment of neoplastic disease appear to offer the greatest likelihood of attaining permanent remission for large numbers of patients. Pilot studies of these regimens are in progress.