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Related Experiment Video

Updated: Mar 21, 2026

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Pro: Cyclophosphamide in lupus nephritis.

Cees G M Kallenberg1

  • 1Department of Rheumatology & Clinical Immunology, AA21, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|May 19, 2016
PubMed
Summary

For proliferative lupus nephritis, low-dose cyclophosphamide (Euro-Lupus regimen) or mycophenolate mofetil (MMF) can induce remission. The Euro-Lupus regimen is favored for long-term data and compliance.

Keywords:
cyclophosphamide, Euro-Lupus Nephritis Triallupus nephritismycophenolate mofetilsystemic lupus erythematosus

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Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Proliferative lupus nephritis requires effective immunosuppressive therapy for remission.
  • Treatment options include cyclophosphamide and mycophenolate mofetil (MMF).

Purpose of the Study:

  • To compare the efficacy and considerations for induction and maintenance therapy in proliferative lupus nephritis.
  • To evaluate the Euro-Lupus Nephritis protocol versus MMF for remission induction.

Main Methods:

  • Review of efficacy and toxicity data for low-dose pulse cyclophosphamide and MMF.
  • Consideration of long-term follow-up, compliance, and economic factors.
  • Assessment of maintenance treatment options including azathioprine (AZA) and MMF.

Main Results:

  • Both low-dose pulse cyclophosphamide (Euro-Lupus protocol) and MMF with corticosteroids are viable for induction therapy.
  • The Euro-Lupus regimen is favored due to long-term data, guaranteed compliance, and cost-effectiveness.
  • For maintenance, AZA is preferred if pregnancy is planned; MMF is preferred for relapses on AZA or post-MMF induction.

Conclusions:

  • The Euro-Lupus Nephritis protocol offers advantages for induction therapy in proliferative lupus nephritis.
  • Treatment choice for maintenance depends on pregnancy plans and prior treatment response.
  • MMF and AZA are effective maintenance options with specific indications.