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New Regimen More Effective for Lupus Nephritis

Multi-drug treatment superior to cyclophosphamide for total remission of lupus nephritis

THURSDAY, July 3 (HealthDay News) -- A combination of mycophenolate mofetil, tacrolimus and steroids is more effective than intravenous cyclophosphamide for inducing complete remission of lupus nephritis, according to an article published online July 2 in the Journal of the American Society of Nephrology.

Hao Bao, M.D., of the Nanjing University School of Medicine in Nanjing, China, and colleagues randomized 40 patients with class V + IV lupus nephritis to receive either combination therapy (mycophenolate mofetil, tacrolimus, steroids) or intravenous cyclophosphamide. Patients were treated for six months and therapy could be extended to nine months if remission was not complete.

In the intention-to-treat analysis, combination therapy achieved greater complete remission than intravenous cyclophosphamide at both six (50 percent versus 5 percent) and nine months (65 percent versus 15 percent), the researchers report. At six months, eight patients (40 percent) in each group experienced partial remission, and at nine months, 30 percent of patients receiving combination therapy and 40 percent of patients receiving intravenous cyclophosphamide did. There were no deaths in either group, and most adverse events were less frequent in the combination therapy group.

"Multi-target therapy with tacrolimus, mycophenolate mofetil and steroids is superior to intravenous cyclophosphamide regimen for inducing complete remission of class V + IV lupus nephritis with few adverse effects," the authors conclude. "This strategy provides us with the opportunity to select an optimized immunosuppressive treatment for patients whose disease is refractory to the conventional therapy."

Roche China and Astellas Ireland Co. provided funding for the study.

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