The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose versus high-dose intravenous cyclophosphamide.
(2010) Annals of the rheumatic diseases — Vol. 69, n° 1, p. 61-64 (2010)
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- OBJECTIVE: To update the follow-up of the Euro-Lupus Nephritis Trial (ELNT), a randomized prospective trial comparing low-dose (LD) versus high-dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment for proliferative lupus nephritis. PATIENTS AND METHODS: Data regarding survival and kidney function were prospectively collected during a 10-year period for the 90 patients randomized in the ELNT, except in 6 lost to follow-up. RESULTS: Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (11% vs 4%, 14% vs 11% and 5% vs 9%, respectively) nor did mean serum creatinine, 24-h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressants and blood pressure lowering drugs. We confirm, after 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy. CONCLUSION: Our data confirm that a LD IVCY regimen followed by AZA - the "Euro-Lupus regimen" - achieves good clinical results in the very long-term.
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Houssiau, F., Vasconcelos, C., D’Cruz, D., Sebastiani, G. D., de Ramon Garrido, E., Danieli, M. G., Abramovicz, D., Blockmans, D., Cauli, A., Direskeneli, H., Galeazzi, M., Gül, A., Levy, Y., Petera, P., Popovic, R., Petrovic, R., Sinico, R. A., Cattaneo, R., Font, J., et al. (2010). The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose versus high-dose intravenous cyclophosphamide. Annals of the rheumatic diseases, 69(1), 61-64. https://doi.org/10.1136/ard.2008.102533 (Original work published 2010)