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学科主题: 临床医学
题名:
Short-interval lower-dose intravenous cyclophosphamide as induction and maintenance therapy for lupus nephritis: a prospective observational study
作者: Zhang, X. W.1; Li, Chun1; Ma, X. X.1; Zhao, J. X.2; An, Yuan1; Liu, Shuang1; Li, Yan1; Li, Z. G.1
关键词: Cyclophosphamide ; Lupus nephritis ; Menstrual disturbance
刊名: CLINICAL RHEUMATOLOGY
发表日期: 2014-07-01
DOI: 10.1007/s10067-014-2590-6
卷: 33, 期:7, 页:939-945
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Rheumatology
研究领域[WOS]: Rheumatology
关键词[WOS]: RANDOMIZED CONTROLLED-TRIAL ; OVARIAN FAILURE ; IMMUNOSUPPRESSIVE THERAPY ; PULSE CYCLOPHOSPHAMIDE ; MYCOPHENOLATE-MOFETIL ; ERYTHEMATOSUS ; AZATHIOPRINE ; PREDNISOLONE ; GLOMERULONEPHRITIS ; METHYLPREDNISOLONE
英文摘要:

Cyclophosphamide (CYC) has long been considered a gold standard in inducing renal remission and preventing renal flares for patients with systemic lupus erythematosus (SLE). However, the rational use of CYC has not reached a consensus, such as the timing and length of treatment, the route of administration, and the ideal dosage. The objective of this study was to assess the efficacy and safety of short-interval lower-dose (SILD) intravenous (IV) CYC in the treatment of SLE. A total of 225 patients with lupus nephritis were randomly assigned to a 1-year trial, either the SILD group (12 fortnightly pulses at a fixed dose of 400 mg followed by 6 monthly pulses) or high-dose (HD) group (6 monthly pulses followed by two quarterly pulses at a dose of 0.5 similar to 1.0 g/m(2)). At 6 months of treatment, 28 % (30/107) of patients in the SILD group reached a complete remission (CR), and 51.4 % (55/107) were in partial remission (PR), as compared with 32.7 % (35/107) and 45.8 % (49/107) in the HD group, respectively. Serum albumin, 24-h urinary protein, and the scores of disease activity were significantly improved in both groups at 6 months and maintained at the end of clinical trial. However, the SILD group showed much less menstrual disturbances (11.5 %), gastrointestinal adverse effects (5.3 %), and leukopenia (9.7 %) than the HD group (28.6, 26.8, and 19.8 %, respectively) at the end of clinical trial. The efficacy of the short-interval lower-dose (SILD) IV CYC regimen in the treatment of lupus nephritis is equivalent to that of the high-dose (HD) regimen, whereas the incidence of adverse events is much lower in the SILD group.

语种: 英语
WOS记录号: WOS:000338324000009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/65052
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Peking Univ, Peoples Hosp, Dept Rheumatol & Immunol, Beijing 100044, Peoples R China
2.Peking Univ, Hosp 3, Dept Rheumatol & Immunol, Beijing 100191, Peoples R China

Recommended Citation:
Zhang, X. W.,Li, Chun,Ma, X. X.,et al. Short-interval lower-dose intravenous cyclophosphamide as induction and maintenance therapy for lupus nephritis: a prospective observational study[J]. CLINICAL RHEUMATOLOGY,2014,33(7):939-945.
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