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Expert Opinion on Investigational Drugs Volume 10, 2001 - Issue 6
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Miscellaneous

Novel approaches in the treatment of lupus nephritis

László Czirják 7624 Pécs, Pacsirta utca 1, Hungary, Tel.: + 36 72 324 122; Fax: +36 72 336 107, E-mail: [email protected]
&
Gabor G Illei National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 9000 Rockville Pike, Building 10, Rm 9S205, Bethesda, MD 20892, USA, Tel.: + 1 301 496 3374; Fax: + 1 301 402 0765, E-mail: [email protected]
Pages 1117-1130 | Published online: 24 Feb 2005

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  • •This study shows poorer outcome with pulse cyclophosphamide in African-Americans.
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  • •Demonstrates normalisation of T-cell receptor repertoire after autologous HSCT in patients with lupus.
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  • ••The only prospective randomisedcontrolled study published so far. Claims equivalency of MMF with cyclophosphamide, however the study has severe methodological limitations.
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  • •Interim results of a study comparing pulse cyclophosphamide, MMF and azathioprine as maintenance therapies in patients who responded to cyclophosphamide. There was no difference among the three arms of the study during the limited follow-up period.
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  • •Good discussion of the topic.
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  • •Results of a multicentre study that found no difference between cyclophosphamide and synchronised plasmapheresis.
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  • •Reports no benefit of pulse/ synchronisation cyclophosphamide/ apheresis over pulse cyclophosphamide alone.
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  • •Demonstrates the synergistic effect of CTLA4-Ig and cyclophosphamide in established murine lupus nephritis.
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  • •Retrospective analysis shows that methylprednisolone alternated monthly with chlorambucil is superior to corticosteroids alone in the treatment of membranous LN.
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  • •Excellent review of the published experience with cyclosporin in membranous lupus nephritis.
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  • ••Preliminary results of a prospectiverandomised controlled trial comparing three treatments for membranous LN. Both alternate month cyclophosphamide and cyclosporin were superior to prednisone alone. Patients treated with cyclophosphamide had fewer flares in the first year treatment than those treated with cyclosporin.
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  • •Soluble receptors of zTNF4 (also known as BAFF, BLyS and TALL-1) reduced proteinuria and improved survival in murine models of SLE.
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  • •The first paper that shows elevated levels of BLyS in human SLE. Although BLyS levels partially correlated with anti-dsDNA titers, no correlation with disease activity was found.
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