High-dose cyclophosphamide versus monthly intravenous cyclophosphamide for systemic lupus erythematosus: a prospective randomized trial.

Arthritis and Rheumatism
Michelle PetriLaurence Magder

Abstract

Monthly intravenous (IV) cyclophosphamide for 6 months has been the standard induction regimen for lupus nephritis, followed by a maintenance regimen of quarterly infusions for 2 years. We undertook this study to compare the efficacy and safety of the standard regimen versus a high-dose IV cyclophosphamide regimen. We performed a prospective randomized trial comparing monthly IV cyclophosphamide at 750 mg/m(2) body surface area for 6 months followed by quarterly IV cyclophosphamide for 2 years (traditional treatment) against high-dose IV cyclophosphamide (50 mg/kg daily for 4 days) (high-dose treatment). Entry criteria included renal lupus, neurologic lupus, or other organ system involvement with moderate-to-severe activity. Fifty-one patients were randomized; 3 withdrew before treatment and 1 committed suicide after 2 months of high-dose treatment. Twenty-two had renal lupus, 14 had neurologic lupus, and 11 had other organ involvement. The outcome measure was the Responder Index for Lupus Erythematosus (complete response, partial response, no change, or worsening). At 6 months (the end of induction), 11 of 21 patients (52%) in the high-dose treatment group had a complete response compared with 9 of 26 patients (35%) in the tra...Continue Reading

References

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Citations

Nov 19, 2013·Best Practice & Research. Clinical Rheumatology·Anna Nuttall, David A Isenberg
Aug 26, 2011·Multiple Sclerosis : Clinical and Laboratory Research·Daniel M HarrisonAdam Kaplin
Jun 1, 2011·Therapeutic Advances in Musculoskeletal Disease·Jacob M van Laar
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Mar 25, 2021·Current Allergy and Asthma Reports·Sendhilnathan Ramalingam, Ankoor Shah

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