ABSTRACT
OBJECTIVE: To update the follow-up of the Euro-Lupus Nephritis Trial (ELNT), a randomised prospective trial comparing low-dose (LD) and high-dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment for proliferative lupus nephritis. PATIENTS AND METHODS: Data for survival and kidney function were prospectively collected during a 10-year period for the 90 patients randomised in the ELNT, except in 6 lost to follow-up. RESULTS: Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (5/44 (11%) vs 2/46 (4%), 6/44 (14%) vs 5/46 (11%) and 2/44 (5%) vs 4/46 (9%), respectively) nor did mean serum creatinine, 24 h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. After 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy was confirmed. CONCLUSION: The data confirm that a LD IVCY regimen followed by AZA-the "Euro-Lupus regimen"-achieves good clinical results in the very long term.
Subject(s)
Cyclophosphamide/administration & dosage , Immunosuppressive Agents/administration & dosage , Lupus Nephritis/drug therapy , Adolescent , Adult , Azathioprine/therapeutic use , Cyclophosphamide/therapeutic use , Dose-Response Relationship, Drug , Drug Therapy, Combination , Epidemiologic Methods , Female , Humans , Immunosuppressive Agents/therapeutic use , Injections, Intravenous , Kidney Function Tests , Lupus Nephritis/physiopathology , Male , Middle Aged , Proteinuria/drug therapy , Treatment Outcome , Young AdultABSTRACT
The "Euro-Lupus Cohort" is composed by 1000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium--the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.
Subject(s)
Autoimmune Diseases/diagnosis , Autoimmune Diseases/epidemiology , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/epidemiology , Age of Onset , Antibodies, Antinuclear/blood , Autoimmune Diseases/blood , Autoimmune Diseases/mortality , Cohort Studies , Europe/epidemiology , Female , Follow-Up Studies , Humans , Lupus Erythematosus, Systemic/blood , Lupus Erythematosus, Systemic/mortality , Male , Morbidity , Prognosis , Prospective Studies , Survival RateABSTRACT
The "Euro-Lupus Cohort" is composed by 1,000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium - the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.
