Pharmacological therapy of lupus nephritis

Research output: Contribution to journalArticle

Abstract

Kidney involvement is common in systemic lupus erythematosus, occurring in up to 60% of affected adults during the course of their disease. Diffuse proliferative lupus nephritis (World Health Organization class IV), the most ominous variant, has traditionally been treated with cyclophosphamide and glucocorticoids. With cyclophosphamide, women of childbearing potential must weigh the risks of sustained amenorrhea, infertility, increased susceptibility to infection, bone marrow suppression, hemorrhagic cystitis, and malignancy against the benefits of better disease control compared with glucocorticoids alone. Because of the host of adverse effects associated with cyclophosphamide, alternative approaches to the treatment of lupus nephritis are desirable. A 31-year-old woman developed class IV lupus nephritis in the postpartum period. Seeking to preserve fertility and avoid other known toxicities of cyclophosphamide, she chose to undergo therapy with mycophenolate mofetil. In the treatment of severe lupus nephritis, mycophenolate mofetil has emerged as an alternative to cyclophosphamide, offering a major advance in the therapy of lupus nephritis.

Original languageEnglish (US)
Pages (from-to)3053-3060
Number of pages8
JournalJournal of the American Medical Association
Volume293
Issue number24
DOIs
StatePublished - Jun 22 2005

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Lupus Nephritis
Cyclophosphamide
Pharmacology
Mycophenolic Acid
Glucocorticoids
Therapeutics
Cystitis
Amenorrhea
Systemic Lupus Erythematosus
Postpartum Period
Infertility
Fertility
Bone Marrow
Kidney
Infection
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pharmacological therapy of lupus nephritis. / Fine, Derek M.

In: Journal of the American Medical Association, Vol. 293, No. 24, 22.06.2005, p. 3053-3060.

Research output: Contribution to journalArticle

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