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THU0280 Extended Follow-Up of the Cyclofa-Lune Trial Comparing Two Sequential Induction and Maintenance Treatment Regimens for Proliferative Lupus Nephritis Based Either on Cyclophosphamide or Cyclosporine a
  1. J. Zavada1,
  2. S. S. Pesickova2,
  3. R. Rysava2,
  4. P. Horak3,
  5. Z. Hrncir4,
  6. J. Lukac5,
  7. J. Rovensky5,
  8. J. Vitova6,
  9. J. Bohmova7,
  10. M. Havrda8,
  11. D. Tegzova1,
  12. M. Olejarova1,
  13. V. Tesar2
  1. 1Institute of Rheumatology
  2. 2Department of Nephrology, General Teaching Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Prague
  3. 3Department of Internal Medicine, Faculty of Medicine, Palacky University, Olomouc
  4. 4Department of Internal Medicine, Faculty of Medicine, Charles University in Prague, Hradec Kralove, Czech Republic
  5. 5National Institute of Rheumatology, Piestany, Slovakia
  6. 6Department of Internal Medicine, Hospital, Ceske Budejovice
  7. 7Faculty Hospital St. Anna, Brno
  8. 8Department of Nephrology, Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

Abstract

Background In the investigator-initiated prospective trial CYLOFA-LUNE [1] we tested the hypothesis that immunosuppressive regimen based on Cyclosporine A (CYA) may have similar efficacy but greater safety than that based on cyclophosphamide (CPH). Lupus patients with biopsy-proven proliferative glomerulonephritis were randomly assigned to a treatment protocol based on either CyA or CPH.

Objectives The main purpose of the current analysis was to ascertain the long-term renal outcome of patients randomised in the CYCLOFA-LUNE trial.

Methods Data for kidney function, and adverse events (death, cardiovascular event, tumor, premature menopause) were collected by a cross-sectional suvey for 38 of 40 patients initially randomised in the CYCLOFA-LUNE trial

Results The median follow-up time was 7.7 years (range 5.0-10.3). Rates of renal impairment and end-stage renal disease, adverse events (death, cardiovascular event, tumor, premature menopause) did not differ between the CPH and CyA group, nor did mean serum creatinine, 24 h proteinuria and SLICC damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents, and blood pressure lowering drugs.

Conclusions The data confirm that both regimens based either on CPH or CyA achieved good and similar clinical results in the very long term

References

  1. Zavada J, Pesickova S, Rysava R, et al. Cyclosporine A or intravenous cyclophosphamide for lupus nephritis: the Cyclofa-Lune study. Lupus. 2010 Oct;19(11):1281-9

Acknowledgements Supported by the project (Ministry of Health, Czech Republic) MZO 00023728.

Disclosure of Interest None Declared

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