期刊
INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES
卷 21, 期 1, 页码 199-206出版社
WILEY
DOI: 10.1111/1756-185X.13152
关键词
combination therapy; lupus nephritis; multiple immunosuppressants; persistent proteinuria
类别
资金
- Division of Rheumatology and Faculty of Medicine, Chiang Mai University, Thailand
ObjectiveTo study the response of lupus nephritis (LN) patients with persistent proteinuria ( 1 g/day after 6 months corticosteroid and single immunosuppressant treatment, or 3 g/day after 3 months of corticosteroid and single immunosuppressant treatment) to corticosteroid combined with two immunosuppressants, and to evaluate associated factors of response within 1 year. MethodA retrospective study of proteinuria and renal function observed in LN patients with persistent proteinuria after adding a second immunosuppressant at 3, 6, 9 and 12 months. ResultTwenty-one LN patients (100.0% female) with persistent proteinuria were treated with corticosteroid and two immunosuppressants (mycophenolate mofetil [MMF] plus cyclosporine A [CSA]). Their mean age and duration from first immunosuppressant to initiating a combination therapy were 33.2 10.2 years and 17.5 +/- 15.7 months, respectively. Twelve (57.1%) patients had proteinuria levels 3 g/day. The renal pathology from 18 patients were Classes III or IV in 11 (61.1%). Fifteen patients (71.4%) responded to treatment (complete remission [CR], proteinuria 0.5 g/day, in seven patients and partial remission [PR], proteinuria reduced > 50%, in eight patients). Changing from a single immunosuppressant to combined immunosuppressants was associated with CR within 1 year (hazards ratio = 0.88; 95% CI = 0.78-0.99). Adverse events consisted of one patient with severe infection, two herpes zoster and one with transient increased serum creatinine level. ConclusionApproximately 70% of LN patients with persistent proteinuria responded to MMF plus CSA. However, infection should be a concern with these patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据