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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Cyclophosphamide and lupus nephritis: when, how, for how long?
Stella Ntali1, George Bertsias, Dimitrios T Boumpas
1Department of Rheumatology, Clinical Immunology, and Allergy, University of Crete Medical School, Voutes, P. O. Box 2209, Heraklion, Greece.
Clinical Reviews in Allergy & Immunology
|January 29, 2010
Summary
Cyclophosphamide (CY) and methyl-prednisolone (MP) pulse therapy is the standard for severe lupus nephritis. Newer agents like mycophenolate mofetil (MMF) offer comparable efficacy with reduced toxicity for less severe cases.
Area of Science:
- Nephrology
- Immunology
- Rheumatology
Background:
- Lupus nephritis management has evolved significantly with immunosuppressive therapies.
- Cyclophosphamide (CY) pulse therapy with methyl-prednisolone (MP) is established as the gold standard for severe cases.
Purpose of the Study:
- To review the current landscape of immunosuppressive therapy for lupus nephritis.
- To compare the efficacy and toxicity profiles of different treatment options.
Main Methods:
- Analysis of randomized controlled trials and long-term observational studies.
- Evaluation of treatment outcomes for cyclophosphamide, methyl-prednisolone, and mycophenolate mofetil.
Main Results:
- CY and MP pulse therapy remains the gold standard for inducing remission in severe lupus nephritis.
- Mycophenolate mofetil (MMF) shows comparable efficacy and reduced gonadal toxicity in moderately severe disease.
- Azathioprine and MMF are effective and commonly used for maintenance therapy due to lower toxicity.
Conclusions:
- While CY/MP is the gold standard for severe lupus nephritis induction, alternative agents are crucial.
- Less toxic maintenance therapies like azathioprine or MMF are vital for long-term lupus nephritis management.
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