Comparison of safety, efficacy and cost between oral pulse cyclophosphamide versus intravenous cyclophosphamide pulse therapy in severe systemic lupus erythematosus

Padiyar, Shivraj; Arya, Sidharth; Surin, Ajit Kumar; Viswanath, Vishad; Danda, Debashish

doi:10.1111/1756-185x.13823

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…As the search was performed in 2019 relevant recent publications could have been missed. For example, Padiyar et al [ 54 ] has recently reported a comparison of the costs of oral CYC compared with intravenous CYC and Bell et al [ 55 ] recently published an abstract reporting the burden of illness in LN; it was reported that patients with LN have significantly higher ambulatory visits, ED visits, hospitalizations, and costs than patients without SLE. Miyazaki et al [ 56 ] also recently reported HCRU of patients with LN compared with patients without central nervous system (CNS) lupus or LN; a higher proportion of patients with LN had ≥ 1 hospitalization compared with patients without CNS lupus or LN.…”

Section: Discussionmentioning

confidence: 99%

The Economic Burden of Lupus Nephritis: A Systematic Literature Review

Thompson¹,

Mahajan²,

Scott³

et al. 2021

Rheumatol Ther

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Introduction Few studies have evaluated the economic burden of lupus nephritis (LN). The aim of this systematic literature review (SLR) was to assess the economic burden (direct and indirect costs, and healthcare resource utilization [HCRU]) associated with LN, with particular focus on the burden of renal flares and end-stage kidney disease (ESKD). Methods This SLR (GSK study 213531) was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches of the MEDLINE and Embase databases were conducted for English language publications reporting cost or HCRU data in patients with LN (regardless of age or LN histological class) until December 10, 2019. Handsearching of conference proceedings and keyword-based searches in PubMed, Google, and Google Scholar were also conducted. Results Twenty-two studies were identified from 28 publications reporting the cost ( n = 19) and HCRU ( n = 13) associated with LN. Most studies were from North America ( n = 13) and many used administrative claims data ( n = 9). LN was associated with substantially higher direct costs (e.g., total annual, hospitalization, and ESKD-related direct costs), total indirect costs, and HCRU (e.g., hospitalization, outpatient services, and medication use) compared with patients without systemic lupus erythematosus (SLE) or non-renal SLE controls. ESKD and dialysis were significant contributors to economic burden. No studies described the cost of renal flares. Conclusions The consensus across the 22 studies was that the economic burden of LN is substantial, particularly in active or severe disease, or if there is progression to ESKD. Total direct cost may be underestimated in claims data given the challenges of identifying patients with LN. Further studies are vital to ascertain the cost of renal flares; a renal flare is likely to result in a period of increased HCRU, which could be mitigated by treatments that extend renal remission. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-021-00368-y.

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Section: Discussionmentioning

confidence: 99%

The Economic Burden of Lupus Nephritis: A Systematic Literature Review

Thompson¹,

Mahajan²,

Scott³

et al. 2021

Rheumatol Ther

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“…This may have obscured the efficacy of CYC, but it revealed side effects because some patients developed infections after receiving a low dose of CYC. Daily oral and pulse intravenous CYC administration have similar efficacies [ 25 , 26 ], which attenuated the heterogeneity of our control group. The short follow-up period, small sample size and the lack of a comparison with RTX at usual dose were also limitations.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of low-dose rituximab as induction therapy for antineutrophil cytoplasmic antibody-associated vasculitis with renal involvement: a Chinese case series

et al. 2023

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Background Rituximab (RTX) is a standard therapy for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). However, the most frequently used dose may lead to severe adverse effects (SAEs). We explored the efficacy and safety of low-dose RTX in Chinese patients with AAV. Methods A total of 22 Chinese patients diagnosed with AAV with renal involvement, including 8 treated with low-dose RTX (400 mg of RTX total over 4 weeks) and 14 treated with cyclophosphamide (CYC), were evaluated. The baseline clinical and pathological data and laboratory parameters during follow-up at months 1, 3, 6, and 12 were collected retrospectively. Results The baseline data showed no significant differences between the two groups. The median peripheral CD19+ cell counts in the RTX group decreased from 315.0/μL to 1.5/μL at 2 weeks, and to 2.5/μL at 1 month after the first dose. The median SCr level decreased from 267.8 μmol/L before treatment to 151.45 μmol/L at 1 month, 132.75 μmol/L at 3 months, 123.2 μmol/L at 6 months, and 151.9 μmol/L at 12 months in RTX-treated patients. The improvements in renal function, proteinuria, and ANCA titre were not significantly different between the two groups. The SAE rate was significantly lower in the RTX group (one SAE of pneumonia) compared with the CYC group. Conclusions This is the first report that low-dose RTX could be effective for the treatment of Chinese patients with AAV with renal involvement.

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Cyclophosphamide

2020

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Comparison of safety, efficacy and cost between oral pulse cyclophosphamide versus intravenous cyclophosphamide pulse therapy in severe systemic lupus erythematosus

Cited by 4 publications

References 13 publications

The Economic Burden of Lupus Nephritis: A Systematic Literature Review

The Economic Burden of Lupus Nephritis: A Systematic Literature Review

Efficacy and safety of low-dose rituximab as induction therapy for antineutrophil cytoplasmic antibody-associated vasculitis with renal involvement: a Chinese case series

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