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Annals of the Rheumatic Diseases 2003;62:799-804
© 2003 by BMJ Publishing Group & European League Against Rheumatism

REVIEW

Treatment of severe proliferative lupus nephritis: the current state

C C Mok 1, R W S Wong 2, K N Lai 2

1 Department of Medicine, Tuen Mun Hospital, Hong Kong, SAR, China
2 Department of Medicine, Queen Mary Hospital, Hong Kong, SAR, China

Correspondence to:
Correspondence to:
Dr C C Mok, Department of Medicine, Tuen Mun Hospital, Tsing Chung Koon Road, New Territories, Hong Kong, China;
ccmok{at}netvigator.com


ABSTRACT
Despite the development of new modalities, cyclophosphamide (CYC) remains the preferred initial treatment for severe proliferative lupus nephritis. Controversies continue about the best route, dosage, and duration of CYC treatment. For recalcitrant disease, new immunosuppressive and immunomodulating agents, immunoablative high dose CYC, nucleoside analogues, apheresis, and the biological response modifiers can be considered.

Keywords: cytotoxicity; glomerulonephritis; immunosuppressive drugs; toxicities

Abbreviations: AZA, azathioprine; CSA, cyclosporin A; CYC, cyclophosphamide; DPGN, diffuse proliferative glomerulonephritis; IVIg, intravenous immunoglobulin; MMF, mycophenolate mofetil; MP, methylprednisolone; NIH, National Institutes of Health; SLE, systemic lupus erythematosus




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