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Article: Lupus nephritis: Induction therapy

TitleLupus nephritis: Induction therapy
Authors
Issue Date2005
PublisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.com
Citation
Lupus, 2005, v. 14 SUPPL. 1, p. s27-s32 How to Cite?
AbstractEffective induction therapy is of pivotal importance in minimizing renal parenchymal damage by the active immune-mediated inflammatory processes in severe proliferative lupus nephritis. Preservation of nephron mass is prerequisite to long-term renal survival. Data from US-based studies have shown improved efficacy with induction treatment comprising corticosteroid and cyclophosphamide, compared with corticosteroid treatment alone. Data from European studies have shown similar efficacy with a modified treatment regimen, in which smaller doses of cyclophosphamide were given at weekly or fortnightly intervals over a shortened treatment duration, and the treatment related adverse effects appeared less frequent with the reduced-dose regimen. We have also reported that sequential immunosuppression with prednisolone and oral cyclophosphamide as induction followed by azathioprine maintenance was associated with a high incidence of remission and relatively favourable long-term renal outcome in Chinese patients. However, cyclophosphamide treatment is associated with considerable adverse effects, which could be potentially fatal. Mycophenolate mofetil selectively inhibits lymphocyte proliferation, and thus targets an instrumental step in the pathogenesis of systemic lupus erythematosus. There is accumulating evidence that the combined use of mycophenolate mofetil and corticosteroid presents an effective treatment for severe proliferative lupus nephritis in different ethnic groups, and is associated with much fewer adverse effects compared with cyclophosphamide-based regimens. Recent data from our group also demonstrate the long-term efficacy of mycophenolate mofetil in preserving renal survival, when used continuously as both induction and maintenance therapy. © 2005 Edward Arnold (Publishers) Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/76544
ISSN
2015 Impact Factor: 2.118
2015 SCImago Journal Rankings: 0.878
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, TMen_HK
dc.date.accessioned2010-09-06T07:22:22Z-
dc.date.available2010-09-06T07:22:22Z-
dc.date.issued2005en_HK
dc.identifier.citationLupus, 2005, v. 14 SUPPL. 1, p. s27-s32en_HK
dc.identifier.issn0961-2033en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76544-
dc.description.abstractEffective induction therapy is of pivotal importance in minimizing renal parenchymal damage by the active immune-mediated inflammatory processes in severe proliferative lupus nephritis. Preservation of nephron mass is prerequisite to long-term renal survival. Data from US-based studies have shown improved efficacy with induction treatment comprising corticosteroid and cyclophosphamide, compared with corticosteroid treatment alone. Data from European studies have shown similar efficacy with a modified treatment regimen, in which smaller doses of cyclophosphamide were given at weekly or fortnightly intervals over a shortened treatment duration, and the treatment related adverse effects appeared less frequent with the reduced-dose regimen. We have also reported that sequential immunosuppression with prednisolone and oral cyclophosphamide as induction followed by azathioprine maintenance was associated with a high incidence of remission and relatively favourable long-term renal outcome in Chinese patients. However, cyclophosphamide treatment is associated with considerable adverse effects, which could be potentially fatal. Mycophenolate mofetil selectively inhibits lymphocyte proliferation, and thus targets an instrumental step in the pathogenesis of systemic lupus erythematosus. There is accumulating evidence that the combined use of mycophenolate mofetil and corticosteroid presents an effective treatment for severe proliferative lupus nephritis in different ethnic groups, and is associated with much fewer adverse effects compared with cyclophosphamide-based regimens. Recent data from our group also demonstrate the long-term efficacy of mycophenolate mofetil in preserving renal survival, when used continuously as both induction and maintenance therapy. © 2005 Edward Arnold (Publishers) Ltd.en_HK
dc.languageengen_HK
dc.publisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.comen_HK
dc.relation.ispartofLupusen_HK
dc.rightsLupus. Copyright © Sage Publications Ltd.en_HK
dc.subject.meshAnti-Inflammatory Agents - administration & dosageen_HK
dc.subject.meshCyclophosphamide - administration & dosageen_HK
dc.subject.meshDose-Response Relationship, Drugen_HK
dc.subject.meshDrug Administration Scheduleen_HK
dc.subject.meshDrug Therapy, Combinationen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunosuppressive Agents - administration & dosageen_HK
dc.subject.meshLupus Nephritis - drug therapyen_HK
dc.subject.meshMycophenolic Acid - administration & dosage - analogs & derivativesen_HK
dc.subject.meshPrednisolone - administration & dosageen_HK
dc.subject.meshRemission Inductionen_HK
dc.titleLupus nephritis: Induction therapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0961-2033&volume=14 Suppl 1&spage=S27&epage=S32&date=2005&atitle=Lupus+nephritis:+induction+therapy.en_HK
dc.identifier.emailChan, TM:dtmchan@hku.hken_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid15803928-
dc.identifier.scopuseid_2-s2.0-16244418389en_HK
dc.identifier.hkuros99031en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-16244418389&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issueSUPPL. 1en_HK
dc.identifier.spages27en_HK
dc.identifier.epages32en_HK
dc.identifier.isiWOS:000228065800006-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK

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