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The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose versus high-dose intravenous cyclophosphamide
  1. Frédéric A Houssiau (frederic.houssiau{at}uclouvain.be)
  1. Université catholique de Louvain, Belgium
    1. Carlos Vasconcelos
    1. Hospital Santo Antonio, Portugal
      1. David D'Cruz
      1. St Thomas' Hospital, United Kingdom
        1. Gian Domenico Sebastiani
        1. Ospedale San Camillo, Italy
          1. Enrique de Ramon Garrido
          1. Hospital Regional del SAS de Malaga, Spain
            1. Maria Giovanna Danieli
            1. Universita Politecnica delle Marche, Italy
              1. Daniel Abramovicz
              1. Hôpital Erasme, Belgium
                1. Daniel Blockmans
                1. Gasthuisberg Academisch Ziekenhuis, Belgium
                  1. Alberto Cauli
                  1. Universita di Cagliari, Italy
                    1. Haner Direskeneli
                    1. University of Marmara Hospital, Turkey
                      1. Mauro Galeazzi
                      1. Universita degli Studi di Siena, Italy
                        1. Ahmet Gül
                        1. University of Istanbul, Turkey
                          1. Yair Levy
                          1. Chaim Sheba Medical Center, Israel
                            1. Peter Petera
                            1. Lainz Hospital, Austria
                              1. Rajko Popovic
                              1. Military Medical Academy, Serbia and Montenegro
                                1. Radmila Petrovic
                                1. University of Belgrade, Serbia and Montenegro
                                  1. Renato A Sinico
                                  1. Ospedale San Carlo Borromeo, Italy
                                    1. Roberto Cattaneo
                                    1. Universita degli Studi di Brescia, Italy
                                      1. Josep Font
                                      1. Hospital Clinic, Spain
                                        1. Geneviève Depresseux
                                        1. Université catholique de Louvain, Belgium
                                          1. Jean-Pierre Cosyns
                                          1. Université catholique de Louvain, Belgium
                                            1. Ricard Cervera
                                            1. Hospital Clinic, Spain

                                              Abstract

                                              Objective: To update the follow-up of the Euro-Lupus Nephritis Trial (ELNT), a randomized prospective trial comparing low-dose (LD) versus high-dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment for proliferative lupus nephritis.

                                              Patients and methods: Data regarding survival and kidney function were prospectively collected during a 10-year period for the 90 patients randomized in the ELNT, except in 6 lost to follow-up.

                                              Results: Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (11% vs 4%, 14% vs 11% and 5% vs 9%, respectively) nor did mean serum creatinine, 24-h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressants and blood pressure lowering drugs. We confirm, after 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy.

                                              Conclusion: Our data confirm that a LD IVCY regimen followed by AZA – the “Euro-Lupus regimen” – achieves good clinical results in the very long-term.

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