Details
| Translated title of the contribution | Lupus Nephritis - New Immuno-suppressive Therapeutic Concepts= Progress? |
|---|---|
| Original language | German |
| Pages (from-to) | 340-345 |
| Number of pages | 6 |
| Journal | Klinikarzt |
| Volume | 32 |
| Issue number | 10 |
| Publication status | Published - 31 Oct 2003 |
| Externally published | Yes |
Abstract
30-50% of all patients suffering from systemic lupus erythematosus (SLE) develop glomerulonephritis. Treatment is determined by the severity of the condition: patients with a proliferative systemic lupus erythematosus benefit most from immunosuppressive therapy. In the case of less severe forms of SLE (WHO grades I and II) or membranous lupus nephritis (WHO grade IV), however, the value of such therapeutic strategies is controversial. Currently, the standard treatment protocol is pulse cyclophosphamide at a low cumulative dose. Since, however, cyclophosphamide may trigger appreciable and even severe side effects (secondary infections, myelosuppression, loss of gonadal function), new treatments are currently being sought with the aim of reducing the cyclophosphamide dose. Already after six months, conversion to maintenance treatment - for example, with azathioptine - is possible in patients who respond to this treatment (renal remission). A more suitable option appears to be mycophenolate mofetil, in particular since the substance has a lower rate of side effects, also in comparison with azathioprine. The sole curative treatment concept, namely stem cell transplantation, is, unfortunately, associated with a high mortality rate, so that this concept should be restricted to young patients with highly active systemic lupus erythematosus and multiorgan failure.
ASJC Scopus subject areas
- Medicine(all)
- General Medicine
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In: Klinikarzt, Vol. 32, No. 10, 31.10.2003, p. 340-345.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Lupusnephritis
T2 - Fortschritt durch neue immunsuppressive Therapiekonzepte?
AU - Blume, Cornelia
AU - Ivens, Katrin
AU - Helmchen, Udo
AU - Grabensee, B.
PY - 2003/10/31
Y1 - 2003/10/31
N2 - 30-50% of all patients suffering from systemic lupus erythematosus (SLE) develop glomerulonephritis. Treatment is determined by the severity of the condition: patients with a proliferative systemic lupus erythematosus benefit most from immunosuppressive therapy. In the case of less severe forms of SLE (WHO grades I and II) or membranous lupus nephritis (WHO grade IV), however, the value of such therapeutic strategies is controversial. Currently, the standard treatment protocol is pulse cyclophosphamide at a low cumulative dose. Since, however, cyclophosphamide may trigger appreciable and even severe side effects (secondary infections, myelosuppression, loss of gonadal function), new treatments are currently being sought with the aim of reducing the cyclophosphamide dose. Already after six months, conversion to maintenance treatment - for example, with azathioptine - is possible in patients who respond to this treatment (renal remission). A more suitable option appears to be mycophenolate mofetil, in particular since the substance has a lower rate of side effects, also in comparison with azathioprine. The sole curative treatment concept, namely stem cell transplantation, is, unfortunately, associated with a high mortality rate, so that this concept should be restricted to young patients with highly active systemic lupus erythematosus and multiorgan failure.
AB - 30-50% of all patients suffering from systemic lupus erythematosus (SLE) develop glomerulonephritis. Treatment is determined by the severity of the condition: patients with a proliferative systemic lupus erythematosus benefit most from immunosuppressive therapy. In the case of less severe forms of SLE (WHO grades I and II) or membranous lupus nephritis (WHO grade IV), however, the value of such therapeutic strategies is controversial. Currently, the standard treatment protocol is pulse cyclophosphamide at a low cumulative dose. Since, however, cyclophosphamide may trigger appreciable and even severe side effects (secondary infections, myelosuppression, loss of gonadal function), new treatments are currently being sought with the aim of reducing the cyclophosphamide dose. Already after six months, conversion to maintenance treatment - for example, with azathioptine - is possible in patients who respond to this treatment (renal remission). A more suitable option appears to be mycophenolate mofetil, in particular since the substance has a lower rate of side effects, also in comparison with azathioprine. The sole curative treatment concept, namely stem cell transplantation, is, unfortunately, associated with a high mortality rate, so that this concept should be restricted to young patients with highly active systemic lupus erythematosus and multiorgan failure.
KW - Glomerulonephritis
KW - Immunosuppresive agents
KW - Pulse cyclophosphamide treatment
KW - Stem cell transplantation
KW - Systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=0242299262&partnerID=8YFLogxK
U2 - 10.1055/s-2003-43279
DO - 10.1055/s-2003-43279
M3 - Artikel
AN - SCOPUS:0242299262
VL - 32
SP - 340
EP - 345
JO - Klinikarzt
JF - Klinikarzt
SN - 0341-2350
IS - 10
ER -