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Rituximab versus oral cyclophosphamide for treatment of relapses of proliferative lupus nephritis: a clinical observational study
  1. Gabriella Moroni1,
  2. Beniamina Gallelli2,
  3. Renato Alberto Sinico3,
  4. Giulio Romano4,
  5. Luigi Sinigaglia5,
  6. Piergiorgio Messa1
  1. 1Divisione di Nefrologia and Dialisi, IRCCS Fondazione Ca' Granda, Ospedale Maggiore, Milano, Italy
  2. 2Unità di Nefrologia e Dialisi, Ospedale S. Anna, Como, Italy
  3. 3Clinical Immunology Unit and Renal Unit, Azienda Ospedaliera Ospedale San Carlo Borromeo, Milano, Italy
  4. 4S.M. Misericordia University Hospital, Nephrology Department, DISM, Udine, Italy
  5. 5Dipartimento di Reumatologia, Unita' Operativa di Day Hospital, Istituto G. Pini, Milano, Italy
  1. Correspondence to Dr Gabriella Moroni, Divisione di Nefrologia e Dialisi—Padiglione Croff, Fondazione Ospedale Maggiore, Mangiagalli, Regina Elena, Via della Commenda 15, 20122 Milano, Italy; gmoroni{at}policlinico.mi.it

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The clinical course of lupus nephritis is characterised by alternation of quiescences and exacerbations. The potential treatment strategies for renal flares are an important issue considering the potential toxicity and the incomplete efficacy of available drugs.1,,4 Among the new agents for induction of remission, rituximab (RTX), an anti-CD20 monoclonal antibody, has emerged as a potential therapeutic alternative.5,,8 In this prospective study, we report the first comparison between RTX and cyclophosphamide (CY) in the treatment of relapses of proliferative lupus nephritis (PLN). From April 2006 to January 2010, 24 patients with established PLN and a new renal relapse discontinued all immunosuppressive drugs and received one intravenous methylprednisolone pulse (MPP) (0.5–1 g each) for 3 days and, based on the patients' choice …

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