The treatment of lupus nephritis with cyclophosphamide and steroids changed the prognosis of lupus nephritis in the early '80s. In recent years, alternative regimens have appeared in both the induction and maintenance with similar results at least to those offered by the classic pattern and possibly with fewer side effects, especially for long term. The association of prednison and mycophenolate has created large expectations to that effect, and is part of first-line therapeutic arsenal of lupus nephritis type III, IV and V. Despite the significant advances that have led to these treatments, the likelihood of complete remission after six months remains, according to the series of 8-13% and partial remission do not exceed 60% in papers published. In the last year, two articles have been published supporting the use of triple therapy (prednisone, mycophenolate, cyclosporine) in poor prognosis of lupus nephritis with hopefully better results than those obtained previously. In this study we try to compare the effectiveness of triple therapy, the therapy is now considered standard (prednisone, mycophenolate) in patients with lupus nephritis type III-IV-V
asd
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Cyclosporine for 26 weeks Prednisone+mycophenolic acid 106 weeks
Mycophenolic Acid + prednison for 106 weeks
Hospital Universitario Fundación Alcorcón
Alcorcón, Madrid, Spain
the number of complete remissions, between the triple therapy with cyclosporine-prednisone-mycophenolic acid and conventional therapy with mycophenolic acid-prednisone as induction therapy in patients with lupus nephritis type III-IV-V
Complete remission: * Proteinuria \< 0.3 g/24h * Albumin normal * eGFR \> 60 mL/min/1.73 m2
Time frame: 36 months
the number of partial and complete remissions, between triple therapy with prednisone, cyclosporine, mycophenolic acid and prednisone-mycophenolic acid.
Partial remission: Proteinuria 0.3-3.5 g/24 hours, with a decrease \> 50% over basal, stable renal function and albumin normal
Time frame: 36 months
the number of patients with adverse effects
Time frame: 36 months
the rate (%) of decline of proteinuria in two groups
Time frame: 36 months
the decrease in GFR (ml/min/1.73m2) in both groups
Time frame: 36 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.