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DOI: 10.1177/0961203308089408
Induction treatment of proliferative lupus nephritis with leflunomide combined with prednisone: a prospective multi-centre observational studyRenal Division, Peking University First Hospital, Beijing, China
Renal Division, Peking University First Hospital, Beijing, China
Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
Renal Division, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
Department of Nephrology, Kidney Center and key Lab of PLA, Chinese General Hospital of PLA, Beijing, China
Renal Division, Huashan Hospital, Fudan University, Shanghai, China
Renal Division, First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
Renal Division, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Department of Rheumatology, The Second Affiliated Hospital, Harbin Medical University, Harbin, China
Department of Nephrology, Shanghai Changzheng Hospital, Shanghai, China
Renal Division, Peking University First Hospital, Beijing, China
Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
Renal Division, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
Department of Nephrology, Kidney Center and key Lab of PLA, Chinese General Hospital of PLA, Beijing, China
Renal Division, Huashan Hospital, Fudan University, Shanghai, China
Renal Division, First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China, why{at}bjmu.edu.cn
Renal Division, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Department of Rheumatology, The Second Affiliated Hospital, Harbin Medical University, Harbin, China
Department of Nephrology, Shanghai Changzheng Hospital, Shanghai, China
Renal Division, Peking University First Hospital, Beijing, China To evaluate the efficacy and safety of leflunomide in the treatment of proliferative lupus nephritis, a prospective multi-centre observational study was conducted. Patients with biopsy proven proliferative lupus nephritis were assigned to receive either leflunomide or cyclophosphamide with concomitant prednisone. Leflunomide was given orally with a loading dose of 1 mg/kg/day for 3 days followed by 30 mg/day. Intravenous cyclophosphamide was administered monthly at a dose of 0.5 g/m2 of body-surface area. A total of 110 patients were enrolled, 70 in the leflunomide group and 40 in the cyclophosphamide group. The complete remission rate in the leflunomide group was 21% and partial remission rate 52%, as compared with 18% and 55%, respectively, in the cyclophosphamide group. Renal parameters and systemic lupus erythematosus disease activity index improved significantly and similarly in both groups. Serum creatinine decreased or stabilized in both treatment groups. No significant difference was noted with respect to clinical outcome between groups. Repeat biopsy also showed a significant reduction of active lesions in kidney pathology after 6 months of leflunomide treatment. Major adverse events, similar in both treatment groups, included infection, alopecia and hypertension. Leflunomide, compared with cyclophosphamide, in combination with prednisone was effective in the induction therapy of proliferative lupus nephritis and was generally well-tolerated.
Key Words: leflunomide • lupus nephritis • multi-centre observational study
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