The safety of pharmacological treatment options for lupus nephritis

被引:6
作者
Velo-Garcia, Alba [1 ,2 ]
Ntatsaki, Eleana [2 ]
Isenberg, David [2 ]
机构
[1] Univ Hosp Complex Pontevedra, Internal Med Dept, Pontevedra, Spain
[2] UCL, Div Med, Ctr Rheumatol, Room 424,Rayne Bldg,5 Univ St, London WC1E 6JF, England
关键词
Safety; treatment; lupus nephritis; cyclophosphamide; biologics; RANDOMIZED CONTROLLED-TRIAL; COATED MYCOPHENOLATE SODIUM; TERM-FOLLOW-UP; LONG-TERM; INTRAVENOUS CYCLOPHOSPHAMIDE; MAINTENANCE THERAPY; CYCLOSPORINE-A; DOUBLE-BLIND; INDUCTION TREATMENT; RISK-FACTORS;
D O I
10.1080/14740338.2016.1182496
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: The management of lupus nephritis (LN) has changed significantly over the last 10 years due to emerging evidence from large randomised clinical trials that produced good quality data and guided the formulation of two key concepts: the induction of remission and the maintenance phase of immunosuppressive therapy. Areas covered: Optimizing cyclophosphamide and glucocorticoid regimens and the introduction of mycophenolate mofetil for proliferative and membranous LN has been pivotal. Nevertheless, concerns remain about treatment toxicity especially long term glucocorticoid use and exposure to cumulative cyclophosphamide doses. Here we discuss the conventional and newer pharmacological options for managing LN focusing on drug safety and toxicity issues. Expert opinion: The need for effective and less toxic treatments led to the development of the role of targeted biologic therapies in LN. However, evidence from the initial randomized controlled trials has been disappointing, although this reflects inadequate trial design rather than true lack of efficacy.
引用
收藏
页码:1041 / 1054
页数:14
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