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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2017 ; 12
(4
): e0175152
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gab.com Text
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English Wikipedia
Comparison of renal response to four different induction therapies in Japanese
patients with lupus nephritis class III or IV: A single-centre retrospective
study
#MMPMID28384208
Hanaoka H
; Kiyokawa T
; Iida H
; Ishimori K
; Takakuwa Y
; Okazaki T
; Yamada H
; Ichikawa D
; Shirai S
; Koike J
; Ozaki S
PLoS One
2017[]; 12
(4
): e0175152
PMID28384208
show ga
The recent recommendations for the management of lupus nephritis suggest that
racial background should be considered while choosing induction therapy. However,
the responses to different induction regimens have been poorly studied in
Japanese population. Here, we assessed the renal response to different induction
therapies in Japanese patients with lupus nephritis class III or IV. The records
of 64 patients with biopsy-proven lupus nephritis class III or IV were
retrospectively evaluated according to therapy received: monthly intravenous
cyclophosphamide (IVCY), the Euro-lupus nephritis trial (ELNT) protocol-IVCY,
tacrolimus (TAC), or mycophenolate mofetil (MMF). We investigated cumulative
complete renal response (CR) rates and relapse rates for each group for 3 years.
Organ damage was assessed with the Systemic Lupus International Collaborating
Clinics/American College of Rheumatology Damage Index (SDI). There were 22
patients on monthly IVCY, 18 on ELNT-IVCY, 13 on TAC, and 11 on MMF. Lower
systemic lupus erythematosus disease activity index (SLEDAI) and higher CH50 were
found in the TAC group at baseline (p<0.01 and p<0.01, respectively). There were
no significant differences of cumulative CR rates and relapse free survival for 3
years among the four different therapeutic regimens (p = 0.2 and p = 0.2,
respectively). There was a tendency to have early response and early relapse in
TAC group and late response in MMF group. The SDI increase over 3 years was found
more frequently in the TAC group than in the monthly-IVCY group (p = 0.04).
Multivariate analysis indicated that CR at 3 months was independent
prognosticator for low damage accrual. Regarding lower damage accrual, early CR
achievement might be essential in induction therapy regardless of
immunosuppressant choice.