Eurolupus cyclophosphamide plus repeated pulses of methyl-prednisolone for the induction therapy of class III, IV and V lupus nephritis

Ruíz-Irastorza, Guillermo; Dueña-Bartolome, Luis; Dunder, Susanna; Varona, Jimena; Gómez-Carballo, Carlota; Dominguez-Cainzos, Jokin; Rodrigo-Manjon, Alejandro; Bueno, Laura López; Richez, Christophe; Duffau, Pierre; Blanco, Patrick; Lazaro, Estibaliz

doi:10.1016/j.autrev.2021.102898

Cited by 19 publications

(12 citation statements)

References 28 publications

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“…This indicates that most patients who achieved a CRR did so in the absence of traditional high‐dose glucocorticoids. These data demonstrate that an immunosuppression regimen with voclosporin is highly effective in LN despite significant reductions in cumulative glucocorticoid dose and add to a growing body of evidence suggesting traditional high‐dose glucocorticoids are not necessary to achieve remission (12,31–33).…”

Section: Discussionmentioning

confidence: 65%

Update on the Efficacy and Safety Profile of Voclosporin: An Integrated Analysis of Clinical Trials in Lupus Nephritis

Arriens

Teng

Ginzler

et al. 2023

Arthritis Care & Research

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Section: Discussionmentioning

confidence: 65%

Update on the Efficacy and Safety Profile of Voclosporin: An Integrated Analysis of Clinical Trials in Lupus Nephritis

Arriens

Teng

Ginzler

et al. 2023

Arthritis Care & Research

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“…Currently, there is no cure for IPF.MP combined with CTX was effective in the treatment of systemic lupus nephritis. In addition, this combination can be used to treat gastric antral vasodilatation in systemic sclerosis and sjogren's associated chronic interstitial nephritis [40][41][42][43][44]. Previous clinical studies have con rmed the safety and e cacy of MP combined with CTX in the treatment of PF [18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Cyclophosphamide combined with methylprednisolone can play a therapeutic role by delaying the aging of pulmonary fibrosis

Zhang

Tang

et al. 2022

Preprint

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Background: Aging is a natural process characterized by a progressive functional impairment and reduced capacity to respond adaptively to environmental stimuli.Idiopathic pulmonary fibrosis(IPF)has been found to increase considerably with age.Immunosenescence,oxidative stress,abnormal shortening of telomeres, apoptosis, and epigenetic changes affecting gene expression have been proposed to contribute to the aging process,and aging-associated diseases. The above indicates that aging can increase the incidence of IPF. So can the occurrence of aging be aggravated after IPF? We examined pathological damage, collagen deposition, oxidative stress and immunosenescence to determine whether bleomycin(BLM)-induced pulmonary fibrosis (PF) accelerates aging in rats. If so, what drugs can inhibit or delay this aging. In clinical studies,the combination of methylprednisolone(MP) and cyclophosphamide(CTX) has shown great benefits in patients with IPF, but its effect on aging resulting from fibrosis is not fully understood. Therefore, we investigated whether MP combined with CTX could delay or inhibit aging in IPF rats. It may provide new targets for the treatment of IPF. Methods: PF rat models were induced by BLM and treated with MP or MP/CTX combination.Transmission electron microscope, hematoxylin and eosin (H&E) and Masson staining were used to measure the morphology of PF. α-SMA and collagen I levels were examined by western blot and immunohistochemistry. Malondialdehyde(MDA),myeloperoxidase(MPO),lutathione peroxidase(GSH-PX) and superoxide dismutase(SOD) levels were determined using commercial kits.T cells were analyzed with flow cytometry. Results: We found that pathological damage, collagen deposition, oxidative stress, and T-cell senescence were increased after BLM-induced PF. The combined use of MP and CTX can alleviate pathological damage, reduce oxidative stress response, such as reducing MDA and MPO levels, and increasing SOD and GSH-PX activities. And inhibition of T cell senescence in lung tissue, such as reduction of CD27-CD28- CD4+ T cells in BLM-induced PF. Conclusions: BLM-induced PF aggravated the occurrence of aging in rats. The combination of MP and CTX can inhibit or delay aging, and thus play a therapeutic role in IPF.These findings provide new insights into the mechanism by which MP and CTX act in combination on IPF.

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“…Oral prednisone dose (or equivalent) and use of other immunomodulatory therapies, antihypertensives, and supportive therapies were recorded at each time point. The dates and doses of methylprednisolone infusions (or equivalent) given during the 12‐month study period were recorded with “pulse” doses defined as ≥125 mg 19 . Dates of rituximab administration 30 days before the start of CYC and up to 12 months were documented.…”

Section: Methodsmentioning

confidence: 99%

Renal Response Outcomes of the EuroLupus and National Institutes of Health Cyclophosphamide Dosing Regimens in Childhood‐Onset Proliferative Lupus Nephritis

Wang,

Sadun,

Zhou

et al. 2024

Arthritis & Rheumatology

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ObjectiveWe compared clinical characteristics and renal response in patients with childhood‐onset proliferative lupus nephritis (LN) treated with the EuroLupus versus NIH cyclophosphamide (CYC) regimen.MethodsA retrospective cohort study was conducted at 11 pediatric centers in North America that reported using both CYC regimens. Data were extracted from the electronic medical record at baseline, 3, 6 and 12 months after treatment initiation with CYC. To evaluate the adjusted association between CYC regimen (EuroLupus vs. NIH) and renal response over time, generalized estimating equations with a logit link were used. An interaction between time and CYC regimen was included, and a contrast between CYC regimens at 12‐months was used to evaluate the primary outcome.ResultsOne hundred and forty‐five patients (58 EuroLupus, 87 NIH) were included. EuroLupus patients were on average older at the start of current cyclophosphamide therapy, had longer disease duration, and more commonly had relapsed or refractory LN compared to the NIH group. After multivariable adjustment, there was no significant association between CYC regimen and achieving complete renal response at 12 months (Odds Ratio (OR) of response for the EuroLupus regimen, reference NIH regimen: 0.76, 95% Confidence Interval (CI) 0.29, 1.98). There was also no significant association between CYC regimen and achieving at least a partial renal response at 12 months (OR 1.35, 95% CI 0.57, 3.19).ConclusionOur study failed to demonstrate a benefit of the NIH regimen over the EuroLupus CYC regimen in childhood‐onset proliferative LN. However, future prospective outcome studies are needed.image

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Eurolupus cyclophosphamide plus repeated pulses of methyl-prednisolone for the induction therapy of class III, IV and V lupus nephritis

Cited by 19 publications

References 28 publications

Update on the Efficacy and Safety Profile of Voclosporin: An Integrated Analysis of Clinical Trials in Lupus Nephritis

Update on the Efficacy and Safety Profile of Voclosporin: An Integrated Analysis of Clinical Trials in Lupus Nephritis

Cyclophosphamide combined with methylprednisolone can play a therapeutic role by delaying the aging of pulmonary fibrosis

Renal Response Outcomes of the EuroLupus and National Institutes of Health Cyclophosphamide Dosing Regimens in Childhood‐Onset Proliferative Lupus Nephritis

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