The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide. Issue 01 (20th January 2009)

• Record Type: Journal Article
• Authors: Houssiau, F A; Vasconcelos, C; D'Cruz, D; Sebastiani, G D; de Ramon Garrido, E; Danieli, M G; Abramovicz, D; Blockmans, D; Cauli, A; Direskeneli, H; Galeazzi, M; Gül, A; Levy, Y; Petera, P; Popovic, R; Petrovic, R; Sinico, R A; Cattaneo, R; Font, J; Depresseux, G; Cosyns, J-P; Cervera, R
• Is Part Of: Annals of the rheumatic diseases. Volume 69:Issue 01(2010)
• Page Start: 61
• Page End: 64
• Publication Date: 2009-01-20
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2008.102533
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objective: To update the follow-up of the Euro-Lupus Nephritis Trial (ELNT), a randomised prospective trial comparing low-dose (LD) and high-dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment for proliferative lupus nephritis. Patients and methods: Data for survival and kidney function were prospectively collected during a 10-year period for the 90 patients randomised in the ELNT, except in 6 lost to follow-up. Results: Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (5/44 (11%) vs 2/46 (4%), 6/44 (14%) vs 5/46 (11%) and 2/44 (5%) vs 4/46 (9%), respectively) nor did mean serum creatinine, 24 h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. After 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy was confirmed. Conclusion: The data confirm that a LD IVCY regimen followed by AZA—the "Euro-Lupus regimen"—achieves good clinical results in the very long term.