The long-term prognosis of lupus nephritis patients treated with intravenous cyclophosphamide.

OBJECTIVE

Patients with lupus nephritis receiving intravenous cyclophosphamide (IVCY) therapy were divided into groups according to their clinical course, and the long-term prognosis was evaluated.

PATIENTS AND METHODS

A total of 67 patients with lupus nephritis were enrolled and divided as follow into the following groups: Group A: patients with fresh nephritis, Group B: patients with relapse nephritis, Group C: patients with nephritis as a transition of the main clinical manifestation. IVCY (500 mg or 750 mg) was administered every month, and continued for two to more than six months.

RESULTS

The rate of remission was 78%; group A revealed a significantly higher rate of remission as compared with the other groups. Although long-term remission was revealed in most patients, some patients in Group B demonstrated a decreased rate of remission. Concerning the total dose administered, there was no relation to prognosis; a high dose was not required, especially for patients in Group A. On the other hand, the combination of steroid pulse therapy with IVCY revealed a moderate relation to the increased rate of remission in Group A. However, this combination therapy was not related to the maintenance of remission. There was no adverse effect at late onset.

CONCLUSION

The long-term prognosis of IVCY differed according to the patient's clinical course, and the result differed from those reported in other countries. Therefore, we should consider the clinical course and race specificity for the Japanese subject.