Randomized controlled trial of pulse/synchronization cyclophosphamide/apheresis for proliferative lupus nephritis
1998; Wiley; Volume: 13; Issue: 4 Linguagem: Inglês
10.1002/(sici)1098-1101(1998)13
ISSN1098-1101
AutoresDaniel J. Wallace, Dennis Goldfinger, Samuel H. Pepkowitz, Marshal Fichman, Allan L. Metzger, Johann O. Schroeder, Hans H. Euler,
Tópico(s)Liver Disease and Transplantation
ResumoOBJECTIVE To assess the efficacy of pulse/synchronization cyclophosphamide/apheresis in patients with proliferative lupus nephritis. METHODS Eighteen patients with Class III or IV renal biopsies and chronicity indices <6 were prospectively randomized to receive 6 courses of parenteral cyclophosphamide over 8 months along with prednisone. Nine of these patients also received 3 daily plasmaphereses prior to each of the 6 courses of cyclophosphamide. Assessments compiled at 6 and 24 months included serum creatinine, albumin, anti DNA, 24-hour urine protein, and C3 complement along with SLAM scores. RESULTS Two out of nine patients in each group evolved end stage renal disease and 3/9 patients in each group went into a renal remission at 24 months. Serum albumin, C3 complement, and SLAM scores improved in both groups, and anti-DNA improved in the pulse/synchronization patients (P < 0.025). No intergroup comparisons were significant. CONCLUSION The addition of pulse/synchronization apheresis to cyclophosphamide therapy does not improve the course of patients with proliferative lupus nephritis. J. Clin. Apheresis 13:163–166, 1998. © 1998 Wiley-Liss, Inc.
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