2006
DOI: 10.1038/sj.ki.5001630
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Azathioprine/methylprednisolone versus cyclophosphamide in proliferative lupus nephritis. A randomized controlled trial

Abstract: Until recently, intravenous cyclophosphamide pulses with oral corticosteroids were regarded standard therapy for proliferative lupus nephritis (LN). Azathioprine, a less toxic alternative, was never proven to be inferior. In the first Dutch lupus nephritis study (enrollment between 1995 and 2001), we randomized 87 proliferative LN patients to either cyclophosphamide pulses (750 mg/m(2), 13 pulses in 2 years) combined with oral prednisone (CY) or to azathioprine (2 mg/kg/day in 2 years) combined with intravenou… Show more

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Cited by 226 publications
(144 citation statements)
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“…In contrast, azathioprine as induction therapy for lupus nephritis has not proven as effective as intravenous cyclophosphamide, with more relapses and less long-term benefit than cytotoxic therapy. 28 Other agents have been explored in induction regimens, typically used in conjunction with MMF and/or steroids. Rituximab, an anti-CD20 monoclonal antibody that depletes B cells, is useful in inducing remissions in some patients with severe lupus nephritis, including those who have failed cyclophosphamide or MMF therapy.…”
Section: Conservative Nonimmunomodulatory Therapy Is Appropriate Formentioning
confidence: 99%
“…In contrast, azathioprine as induction therapy for lupus nephritis has not proven as effective as intravenous cyclophosphamide, with more relapses and less long-term benefit than cytotoxic therapy. 28 Other agents have been explored in induction regimens, typically used in conjunction with MMF and/or steroids. Rituximab, an anti-CD20 monoclonal antibody that depletes B cells, is useful in inducing remissions in some patients with severe lupus nephritis, including those who have failed cyclophosphamide or MMF therapy.…”
Section: Conservative Nonimmunomodulatory Therapy Is Appropriate Formentioning
confidence: 99%
“…In fact, the greater corticosteroid exposure in the AZA plus MP group could account for the increased incidence of infections in that group (2). It follows that the lesser efficacy of the AZA plus MP regimen might have been even more evident if the corticosteroid dosing in the 2 regimens were identical.…”
mentioning
confidence: 99%
“…The study included Ͼ60% of all patients with biopsy-proven proliferative lupus nephritis in the Dutch Lupus Nephritis Study (2). The exclusion of patients with creatinine clearance rates Ͻ25 ml/minute can explain the rarity of crescents found on renal biopsy.…”
mentioning
confidence: 99%
“…La exposición a corticosteroides aumenta el riesgo de reactivación del virus varicela-zoster en la forma de herpes zoster 6,23,24 . La frecuencia de herpes zoster es aproximadamente tres veces superior a lo observado en otros pacientes con condiciones músculo-esqueléticas no inflamatorias y tiende a concentrarse poco después del diagnóstico pero no necesariamente se presenta en el momento de estar tomando fármacos inmunosupresores 25 .…”
Section: Infecciones Viralesunclassified