Treatment of proliferative lupus nephritis: a changing landscape

Grootscholten et al. report a randomized controlled trial comparing azathioprine plus intravenous methylprednisolone and oral prednisolone (AZA group) with intermittent intravenous cyclophosphamide and oral prednisolone (CY group) in patients with proliferative lupus nephritis. AZA-treated patients were more likely to develop non-sustained doubling of their serum creatinine, although not significantly so, and significantly more likely to have a relapse of their nephritis than CY-treated patients.