Lupus nephritis treatment

Plane RS, Roberts MA, Strippoli GEM, Chadban SJ, Kerr PG, Atkins RC. Treatment for lupus nephritis. Cochrane Database Syst Rev 2004. 

Lupus nephritis is the most common manifestation of inadequately treated SLE. Its therapy serves as a module for treatment of other lupus manifestations. 

Darmawan J, Zhao DB, Soorosh GS, Chen S-L, Haq SY. Sustained remission in DMARD-refractory Lupus nephritis treated with step-down bridge comhination therapy of five immunosuppressants without corticosteroids a six years international study in Asia -WHO-ILAR COPCORD Stage 11 treatment. APLAR J Rheumatol 2007 10 in press. 

In a 15-year-old boy with previously quiescent lupus nephritis, laboratory markers of disease activity rose during somatropin treatment and returned to baseline concentrations within 3 months after withdrawal (88). 

All of these therapies are under development. The treatment of SLE is still a challenging task for the physician. The importance of the effective treatment of lupus nephritis is reflected by the results of mass urinary screening for school children in Taiwan The most important secondary glomerulonephritis discovered by the screening is SLE with lupus nephritis (L19). In order to achieve a better prognosis, physicians need to be familiar with the effects of autoantibodies, diagnose SLE early, and treat it with appropriate methods. 

Valeri A, Radhakrishnan J, Estes D, D Agati V, Kopehnan R, Pernis A, Flis R, Pirani C, Appel GB (1994) Intravenous pulse cyclophosphamide treatment of severe lupus nephritis a prospective five-year study. Clin Nephrol 42 71-78. 

In September 2000, the US FDA granted orphan drug status to abetimus for the treatment of lupus nephritis the EU did hkewise in November 2001. 

Skin-test reactivity, that is induration and tissue factor generation by monocjdes, is reduced by therapeutic doses of oral anticoagulants, but Ijmphocyte transformation activity is not. This constitutes the rationale for the use of oral anticoagulants in the treatment of immune diseases characterized by fibrin deposition, such as allograft rejection and lupus nephritis (70). 

Levy Y, Sherer Y, George J, Rovensky J, Lukac J, Rauova L, Poprac P, Langevitz P, Fabbrizzi F, Shoenfeld Y. Intravenous immunoglobulin treatment of lupus nephritis. Semin Arthritis Rheum 2000 29(5) 321-7. 

Tanaka H, Tsugawa K, Tsuruga K, Suzuki K, Nakahata T, Ito E, Waga S. Mizoribine for the treatment of lupus nephritis in children and adolescents. Clin Nephrol 2004 62(6) 412-17. 

Tse KC, Lam MF,Tang SC, Tang CS, Chan TM. A pilot study on tacrolimus treatment in membranous or quiescent lupus nephritis with proteinuria resistant to angiotensin inhibition or blockade. Lupus 2007 16 46-51. 

Clinical trials have revealed that diseases that are related directly to excessive TNF production, such as septic shock, GVHD, and lupus nephritis, may be amenable to treatment either with anti-TNFa antibodies or with antiinflammatory agents that reduce TNF production, such as cyclosporin A and steroids. ... 

The optimal treatment for lupus nephritis depends on the underlying lesion and disease activity, as well as the severity and duration of the clinical presentation. 

Bansal VK, Beto JA. Treatment of lupus nephritis A meta-analysis of clinical trials. Am J Kidney Dis 1997 29 193-199. 

Austin HA, Balow JE. Treatment of lupus nephritis. Semin Nephrol 2000 20 265-276. 

There is a paucity of quality evidence for the treatment of SLE except for lupus nephritis. 

Evidence supporting the use of cyclophosphamide in lupus nephritis has been collected over the last several decades. Controlled clinical trials have shown that cyclophosphamide improved the longterm outcomes in lupus nephritis. " Based on controlled trials, combination prednisone and cyclophosphamide has become standard treatment for focal and diffuse proliferative lupus nephritis (WHO class III/IV) and is superior to prednisone alone. There are no studies examining cyclophosphamide in earlier stages of nephritis (WHO class II/III), and therefore, corticosteroids remain the treatment of... 

Mok CC, Wong RWS, Lai KN. Treatment of severe proliferative lupus nephritis the current state. Ann Rheum Dis 2003 62 799-804. 

Fu LW, Yang LY, Chen WP, Lin CY. Clinical efficacy of cyclosporin a ne-oral in the treatment of paediatric lupus nephritis with heavy proteinuria. BrJ Rheumatol 1998 37 217-221. 

Mclnnes PM, Schuttinga J, Sanslone WR, et al. The economic impact of treatment of severe lupus nephritis with prednisone and intravenous cyclophosphamide. Arthritis Rheum 1994 37 1000-1006. 

Systematic reviews Adverse events in five randomized controlled comparisons of mycophenolate mofetil and cyclophosphamide in the treatment of lupus nephritis in 638 patients have been analysed Infection rates, renal function, and gastrointestinal symptoms were not significantly different, except for leukopenia, which was more common with cyclophosphamide. 

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