TY - JOUR
T1 - Cyclosporine for the treatment of lupus nephritis in patients with systemic lupus erythematosus
AU - Yang, Tzu Han
AU - Wu, Tsai Hung
AU - Chang, Yuh Lih
AU - Liao, Hsien Tzung
AU - Hsu, Chia Chen
AU - Tsai, Chang Youh
AU - Chou, Yueh Ching
N1 - Funding Information:
The authors disclose receipt of the following financial support for the research, authorship, and/or publication of this article: Taipei Veterans General Hospital (V105C-114) and the Ministry of Science & Technology (MOST105-2314-B075-064).
Publisher Copyright:
© 2018, Dustri-Verlag Dr. K. Feistle.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Aims: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). Materials and methods: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/ creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded. Renal response to CsA (complete response (CR) and partial response (PR)) and relapse after stopping CsA were set as primary endpoint, and adverse events, progression to end-stage renal disease (ESRD), and all-cause mortality as secondary endpoint. Results: Among 60 patients enrolled, 11.7%, 20%, 25% achieved CR and 65.0%, 51.7%, 40% achieved PR at 1, 6, and 12 months, respectively. The SCr and eGFR remained stable during follow-up. After 1 year, CsA led to a decrease in median uPCR (3.79 to 0.51, p < 0.001) and anti-dsDNA (10.1 to 5.7 IU/ mL, p = 0.011), an increase in mean C3 (75.9 to 88.5 mg/dL, p < 0.001) and C4 (15.9 to 19.5 mg/dL, p < 0.001) as well as a decrease in glucocorticoid dose. There were no deaths or progression to ESRD originating from adverse events in our study. Conclusion: CsA is an effective and safe treatment for patients with LN. Further randomized controlled trials are needed.
AB - Aims: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). Materials and methods: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/ creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded. Renal response to CsA (complete response (CR) and partial response (PR)) and relapse after stopping CsA were set as primary endpoint, and adverse events, progression to end-stage renal disease (ESRD), and all-cause mortality as secondary endpoint. Results: Among 60 patients enrolled, 11.7%, 20%, 25% achieved CR and 65.0%, 51.7%, 40% achieved PR at 1, 6, and 12 months, respectively. The SCr and eGFR remained stable during follow-up. After 1 year, CsA led to a decrease in median uPCR (3.79 to 0.51, p < 0.001) and anti-dsDNA (10.1 to 5.7 IU/ mL, p = 0.011), an increase in mean C3 (75.9 to 88.5 mg/dL, p < 0.001) and C4 (15.9 to 19.5 mg/dL, p < 0.001) as well as a decrease in glucocorticoid dose. There were no deaths or progression to ESRD originating from adverse events in our study. Conclusion: CsA is an effective and safe treatment for patients with LN. Further randomized controlled trials are needed.
KW - Cyclosporine
KW - Lupus
KW - Nephritis
KW - Proteinuria
KW - Relapse
KW - Systemic lupus erythematosus.
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U2 - 10.5414/CN109325
DO - 10.5414/CN109325
M3 - Article
AN - SCOPUS:85043354031
SN - 0301-0430
VL - 89
SP - 277
EP - 285
JO - Clinical Nephrology
JF - Clinical Nephrology
IS - 4
ER -