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Efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients.

Bozzolo, Enrica P; Ramirez, Giuseppe A; Bonavida, Giovanna; Lanzani, Chiara; Scotti, Raffaella; Dell'antonio, Giacomo; Baldissera, Elena; Canti, Valentina; Manfredi, Angelo A; Rovere-Querini, Patrizia; Sabbadini, Maria Grazia.
Autoimmunity; 46(8): 537-46, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23944610

OBJECTIVE:

To study efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients.

METHODS:

The case records of 40 patients with lupus nephritis followed up in a single center between 1992 and 2011 (median duration = 8.37 years) were retrieved to determine efficacy and toxicity of the treatments. Patients with class III/IV/V lupus nephritis were included.

RESULTS:

Sustained responses were 21/40 (52.5%) at six months, 33/40 (82.5%) at 18 months and 30/40 (75.0%) at 36 months. Three deaths were observed after 18, 104 and 164 months of follow-up respectively, with one possibly associated with immunosuppression. Kidney survival was 100% at 18 months and 97.7% at 36 months. Kaplan-Meier's survival algorithm estimated a mean overall survival of 236.05 ± 11.56 months and a kidney survival of 240.77 ± 11.07 months. Kidney and overall survival were not significantly different among patients with different nephritis classes. Complications occurred in 12/40 (30.0%). Amenorrhea occurred in 20.7% of patients and was associated with higher cumulative doses of cyclophosphamide. Patients who achieved remission at 36 months or later had lower levels of proteinuria at 6 months (mean ± SD = 0.93 ± 0.97 g/24 h versus 2.60 ± 2.11 g/24 h, p = 0.002) than non-responder patients.

CONCLUSIONS:

The data demonstrate that in the overall Caucasian population with lupus nephritis the combination of available therapeutic tools is effective and relatively well tolerated.
Selo DaSilva