The kidney in rheumatological disorders
Treatment of lupus nephritis—(1) recent publications show lower rates of renal flare in patients taking hydroxychloroquine; (2) in class V (membranous) disease ciclosporin and pulsed intravenous cyclophosphamide have both been shown to be better at inducing remission than prednisolone alone; other studies have shown that cyclophosphamide and mycophenolate mofetil are probably of equal efficacy; (3) 10-year follow up from the Euro-lupus trials shows that azathioprine is a very effective maintenance agent; (4) recent trials of biologic agents are discussed; many have not proved to be efficacious, but early results with the B-cell modulator belimumab (a human anti-BLyS antibody) show promise.
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