Cyclophosphamide and Lupus Nephritis: When, How, For How Long?
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Stella Ntali & George Bertsias & Dimitrios T. Boumpas
- چاپ و سال / کشور: 2011
Description
Ever since the introduction of cyclophosphamide (CY), the management of lupus nephritis has dramatically changed, and its prognosis has greatly improved. Based on randomized controlled trials and long-term observational studies, pulse therapy with CY in combination with methylprednisolone (MP) is the “gold standard” of therapy for severe lupus. The realization of the significant gonadal toxicity intensified the efforts for the development of alternative immunosuppressive agents. In a large, randomized controlled trial, newer agents such as mycophenolate mofetil (MMF) have demonstrated comparable efficacy and less toxicity for moderately severe disease. To date, combinations of monthly pulses of CY with MP remain the gold standard for the induction of remission in severe lupus. For maintenance, less toxic agents such as azathioprine or MMF are equally effective and are routinely used in the current therapy of lupus
Clinic Rev Allerg Immunol (2011) 40:181–191 Published online: 28 January 2010
