A new treatment using a combination of drugs targeting different parts of the immune system improves the recovery rate for patients with severe lupus involving the kidneys, according to a report in the October Journal of the American Society of Nephrology (JASN).
"In our study, multi-target therapy is shown to be superior to traditional therapy for inducing complete remission of class V+IV lupus nephritis, with few side effects," comments Dr. Lei-Shi Li of the Research Institute of Nephrology of Jinling Hospital, Nanjing University School of Medicine in Nanjing,China.
The study included 40 patients with severe lupus nephritis. Lupus nephritis is inflammation of the kidneys occurring in patients with the immune system disease systemic lupus erythematosus (SLE). All patients had "class V+IV" disease, meaning widespread inflammation and decreasing function of the kidneys. "This is a severe form of lupus nephritis that is traditionally treated with a single immunosuppressant drug, but the efficacy is very poor," says Dr. Li. "We considered that, since the impact of severe SLE on the kidney involves various parts of the immune system, it is necessary to treat the different immune targets with a combination of immunosuppressant drugs."
One group of patients received this "multi-target" therapy, consisting of the immunosuppressant drugs tacrolimus and mycophenolate mofetilcommonly used as anti-rejection drugs in transplant patientsplus a steroid. The other group received standard treatment with a single immunosuppressant drug (cyclophosphamide).
The complete remission rate, with recovery of normal kidney function, was about four times higher among patients receiving the three-drug combination. "For patients receiving multi-target therapy, the complete remission rate reached 65 percent at nine months, versus only 15 percent under traditional therapy," says Dr. Li.
Some patients in both groups had partial remiss
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American Society of Nephrology