Background In the investigator-initiated prospective trial CYLOFA-LUNE  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
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