Cyclosporine for the treatment of lupus nephritis in patients with systemic lupus erythematosus

Tzu Han Yang, Tsai Hung Wu, Yuh Lih Chang, Hsien Tzung Liao, Chia Chen Hsu, Chang Youh Tsai, Yueh Ching Chou

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aims: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). Materials and methods: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/ creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded. Renal response to CsA (complete response (CR) and partial response (PR)) and relapse after stopping CsA were set as primary endpoint, and adverse events, progression to end-stage renal disease (ESRD), and all-cause mortality as secondary endpoint. Results: Among 60 patients enrolled, 11.7%, 20%, 25% achieved CR and 65.0%, 51.7%, 40% achieved PR at 1, 6, and 12 months, respectively. The SCr and eGFR remained stable during follow-up. After 1 year, CsA led to a decrease in median uPCR (3.79 to 0.51, p < 0.001) and anti-dsDNA (10.1 to 5.7 IU/ mL, p = 0.011), an increase in mean C3 (75.9 to 88.5 mg/dL, p < 0.001) and C4 (15.9 to 19.5 mg/dL, p < 0.001) as well as a decrease in glucocorticoid dose. There were no deaths or progression to ESRD originating from adverse events in our study. Conclusion: CsA is an effective and safe treatment for patients with LN. Further randomized controlled trials are needed.

Original languageEnglish
Pages (from-to)277-285
Number of pages9
JournalClinical Nephrology
Volume89
Issue number4
DOIs
Publication statusPublished - Apr 1 2018
Externally publishedYes

Fingerprint

Lupus Nephritis
Systemic Lupus Erythematosus
Cyclosporine
Creatinine
Glomerular Filtration Rate
Therapeutics
Chronic Kidney Failure
Urine
Complement C3
Antibodies
DNA
Serum
Glucocorticoids
Proteins
Randomized Controlled Trials
Kidney
Safety
Recurrence
Mortality

Keywords

  • Cyclosporine
  • Lupus
  • Nephritis
  • Proteinuria
  • Relapse
  • Systemic lupus erythematosus.

ASJC Scopus subject areas

  • Nephrology

Cite this

Yang, T. H., Wu, T. H., Chang, Y. L., Liao, H. T., Hsu, C. C., Tsai, C. Y., & Chou, Y. C. (2018). Cyclosporine for the treatment of lupus nephritis in patients with systemic lupus erythematosus. Clinical Nephrology, 89(4), 277-285. https://doi.org/10.5414/CN109325

Cyclosporine for the treatment of lupus nephritis in patients with systemic lupus erythematosus. / Yang, Tzu Han; Wu, Tsai Hung; Chang, Yuh Lih; Liao, Hsien Tzung; Hsu, Chia Chen; Tsai, Chang Youh; Chou, Yueh Ching.

In: Clinical Nephrology, Vol. 89, No. 4, 01.04.2018, p. 277-285.

Research output: Contribution to journalArticle

Yang, TH, Wu, TH, Chang, YL, Liao, HT, Hsu, CC, Tsai, CY & Chou, YC 2018, 'Cyclosporine for the treatment of lupus nephritis in patients with systemic lupus erythematosus', Clinical Nephrology, vol. 89, no. 4, pp. 277-285. https://doi.org/10.5414/CN109325
Yang, Tzu Han ; Wu, Tsai Hung ; Chang, Yuh Lih ; Liao, Hsien Tzung ; Hsu, Chia Chen ; Tsai, Chang Youh ; Chou, Yueh Ching. / Cyclosporine for the treatment of lupus nephritis in patients with systemic lupus erythematosus. In: Clinical Nephrology. 2018 ; Vol. 89, No. 4. pp. 277-285.
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abstract = "Aims: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). Materials and methods: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/ creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded. Renal response to CsA (complete response (CR) and partial response (PR)) and relapse after stopping CsA were set as primary endpoint, and adverse events, progression to end-stage renal disease (ESRD), and all-cause mortality as secondary endpoint. Results: Among 60 patients enrolled, 11.7{\%}, 20{\%}, 25{\%} achieved CR and 65.0{\%}, 51.7{\%}, 40{\%} achieved PR at 1, 6, and 12 months, respectively. The SCr and eGFR remained stable during follow-up. After 1 year, CsA led to a decrease in median uPCR (3.79 to 0.51, p < 0.001) and anti-dsDNA (10.1 to 5.7 IU/ mL, p = 0.011), an increase in mean C3 (75.9 to 88.5 mg/dL, p < 0.001) and C4 (15.9 to 19.5 mg/dL, p < 0.001) as well as a decrease in glucocorticoid dose. There were no deaths or progression to ESRD originating from adverse events in our study. Conclusion: CsA is an effective and safe treatment for patients with LN. Further randomized controlled trials are needed.",
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AU - Wu, Tsai Hung

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AU - Liao, Hsien Tzung

AU - Hsu, Chia Chen

AU - Tsai, Chang Youh

AU - Chou, Yueh Ching

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AB - Aims: This study aimed to assess retrospectively the efficacy and safety of cyclosporin A (CsA) therapy in patients with lupus nephritis (LN). Materials and methods: From September 2005 to August 2015, eligible patients with LN undergoing CsA treatment were enrolled in the study. Medical charts as well as clinical and laboratory data were retrospectively reviewed. The data were evaluated at 0, 1, 6, 12 month(s) after the start of CsA. Serum creatinine (SCr), estimated glomerular filtration rate (eGFR), urine protein/ creatinine ratio (uPCR), complement components C3, C4, and anti-double stranded DNA antibody (anti-dsDNA) titers were recorded. Renal response to CsA (complete response (CR) and partial response (PR)) and relapse after stopping CsA were set as primary endpoint, and adverse events, progression to end-stage renal disease (ESRD), and all-cause mortality as secondary endpoint. Results: Among 60 patients enrolled, 11.7%, 20%, 25% achieved CR and 65.0%, 51.7%, 40% achieved PR at 1, 6, and 12 months, respectively. The SCr and eGFR remained stable during follow-up. After 1 year, CsA led to a decrease in median uPCR (3.79 to 0.51, p < 0.001) and anti-dsDNA (10.1 to 5.7 IU/ mL, p = 0.011), an increase in mean C3 (75.9 to 88.5 mg/dL, p < 0.001) and C4 (15.9 to 19.5 mg/dL, p < 0.001) as well as a decrease in glucocorticoid dose. There were no deaths or progression to ESRD originating from adverse events in our study. Conclusion: CsA is an effective and safe treatment for patients with LN. Further randomized controlled trials are needed.

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KW - Proteinuria

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