Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis

H. J. Dinant, J. L. Decker, J. H. Klippel, J. E. Balow, P. H. Plotz, A. D. Steinberg

Research output: Contribution to journalArticle

Abstract

Forty-one patients with systemic lupus erythematosus and glomerulonephritis were studied in a randomized drug trial. Thirteen patients received prednisone only (Group 1), 16 received oral cyclophosphamide and oral azathioprine (1 mg/kg body weight/day of each initially) (Group 2), and 12 were given boluses of intravenous cyclophosphamide (0.5 to 1.0 g/m2 body surface area every 3 months) (Group 3). The mean observation period was 42 months (range 1 to 6.5 years). Renal function deteriorated in four of 12 patients in Group 1 and three of 27 patients in Groups 2 and 3 (p = 0.114). By life-table analysis, 86% of the entire group survived 5 years after entry to the study. Marked hypertension, fluctuating changes in serum creatinine, erratic changes in levels of antibody to DNA, reduced C3 levels, increasing proteinuria or sustained hematuria, and flares of extra-renal disease activity occurred more commonly in Group 1. Infectious complications were not commoner in Groups 2 and 3. We conclude that any marginal benefits produced by the programs tested cannot be shown in this class of patients without markedly increasing the sample size. Our current studies involve more vigorous treatment of patients with more acute disease and less treatment during prolonged periods of relatively good health.

Original languageEnglish (US)
Pages (from-to)728-736
Number of pages9
JournalAnnals of Internal Medicine
Volume96
Issue number6 I
StatePublished - 1982
Externally publishedYes

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Lupus Nephritis
Azathioprine
Cyclophosphamide
Therapeutics
Kidney
Life Tables
Body Surface Area
Acute Disease
Hematuria
Prednisone
Proteinuria
Systemic Lupus Erythematosus
Sample Size
Creatinine
Body Weight
Observation
Hypertension
Antibodies
DNA
Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Dinant, H. J., Decker, J. L., Klippel, J. H., Balow, J. E., Plotz, P. H., & Steinberg, A. D. (1982). Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis. Annals of Internal Medicine, 96(6 I), 728-736.

Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis. / Dinant, H. J.; Decker, J. L.; Klippel, J. H.; Balow, J. E.; Plotz, P. H.; Steinberg, A. D.

In: Annals of Internal Medicine, Vol. 96, No. 6 I, 1982, p. 728-736.

Research output: Contribution to journalArticle

Dinant, HJ, Decker, JL, Klippel, JH, Balow, JE, Plotz, PH & Steinberg, AD 1982, 'Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis', Annals of Internal Medicine, vol. 96, no. 6 I, pp. 728-736.
Dinant HJ, Decker JL, Klippel JH, Balow JE, Plotz PH, Steinberg AD. Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis. Annals of Internal Medicine. 1982;96(6 I):728-736.
Dinant, H. J. ; Decker, J. L. ; Klippel, J. H. ; Balow, J. E. ; Plotz, P. H. ; Steinberg, A. D. / Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis. In: Annals of Internal Medicine. 1982 ; Vol. 96, No. 6 I. pp. 728-736.
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