Efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients

Enrica P. Bozzolo, Giuseppe A. Ramirez, Giovanna Bonavida, Chiara Lanzani, Raffaella Scotti, Giacomo Dell'Antonio, Elena Baldissera, Valentina Canti, Angelo A. Manfredi, Patrizia Rovere-Querini, Maria Grazia Sabbadini

Research output: Contribution to journalArticle

Abstract

Objective: To study efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients. Methods: The case records of 40 patients with lupus nephritis followed up in a single center between 1992 and 2011 (median duration=8.37 years) were retrieved to determine efficacy and toxicity of the treatments. Patients with class III/IV/V lupus nephritis were included. Results: Sustained responses were 21/40 (52.5%) at six months, 33/40 (82.5%) at 18 months and 30/40 (75.0%) at 36 months. Three deaths were observed after 18, 104 and 164 months of follow-up respectively, with one possibly associated with immunosuppression. Kidney survival was 100% at 18 months and 97.7% at 36 months. Kaplan-Meier's survival algorithm estimated a mean overall survival of 236.05±11.56 months and a kidney survival of 240.77± 11.07 months. Kidney and overall survival were not significantly different among patients with different nephritis classes. Complications occurred in 12/40 (30.0%). Amenorrhea occurred in 20.7% of patients and was associated with higher cumulative doses of cyclophosphamide. Patients who achieved remission at 36 months or later had lower levels of proteinuria at 6 months (mean± SD=0.93 ±0.97g/24 h versus 2.60± 2.11g/24h, p =0.002) than non-responder patients. Conclusions: The data demonstrate that in the overall Caucasian population with lupus nephritis the combination of available therapeutic tools is effective and relatively well tolerated.

Original languageEnglish
Pages (from-to)537-546
Number of pages10
JournalAutoimmunity
Volume46
Issue number8
DOIs
Publication statusPublished - Dec 2013

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Nephritis
Lupus Nephritis
Kidney
Survival
Amenorrhea
Proteinuria
Cyclophosphamide
Immunosuppression
Population

Keywords

  • Drug-related toxicity
  • Immunosuppression
  • Nephritistherapy
  • Overall survival
  • Renal function
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Bozzolo, E. P., Ramirez, G. A., Bonavida, G., Lanzani, C., Scotti, R., Dell'Antonio, G., ... Sabbadini, M. G. (2013). Efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients. Autoimmunity, 46(8), 537-546. https://doi.org/10.3109/08916934.2013.817560

Efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients. / Bozzolo, Enrica P.; Ramirez, Giuseppe A.; Bonavida, Giovanna; Lanzani, Chiara; Scotti, Raffaella; Dell'Antonio, Giacomo; Baldissera, Elena; Canti, Valentina; Manfredi, Angelo A.; Rovere-Querini, Patrizia; Sabbadini, Maria Grazia.

In: Autoimmunity, Vol. 46, No. 8, 12.2013, p. 537-546.

Research output: Contribution to journalArticle

Bozzolo, EP, Ramirez, GA, Bonavida, G, Lanzani, C, Scotti, R, Dell'Antonio, G, Baldissera, E, Canti, V, Manfredi, AA, Rovere-Querini, P & Sabbadini, MG 2013, 'Efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients', Autoimmunity, vol. 46, no. 8, pp. 537-546. https://doi.org/10.3109/08916934.2013.817560
Bozzolo, Enrica P. ; Ramirez, Giuseppe A. ; Bonavida, Giovanna ; Lanzani, Chiara ; Scotti, Raffaella ; Dell'Antonio, Giacomo ; Baldissera, Elena ; Canti, Valentina ; Manfredi, Angelo A. ; Rovere-Querini, Patrizia ; Sabbadini, Maria Grazia. / Efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients. In: Autoimmunity. 2013 ; Vol. 46, No. 8. pp. 537-546.
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AU - Scotti, Raffaella

AU - Dell'Antonio, Giacomo

AU - Baldissera, Elena

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AU - Manfredi, Angelo A.

AU - Rovere-Querini, Patrizia

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N2 - Objective: To study efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients. Methods: The case records of 40 patients with lupus nephritis followed up in a single center between 1992 and 2011 (median duration=8.37 years) were retrieved to determine efficacy and toxicity of the treatments. Patients with class III/IV/V lupus nephritis were included. Results: Sustained responses were 21/40 (52.5%) at six months, 33/40 (82.5%) at 18 months and 30/40 (75.0%) at 36 months. Three deaths were observed after 18, 104 and 164 months of follow-up respectively, with one possibly associated with immunosuppression. Kidney survival was 100% at 18 months and 97.7% at 36 months. Kaplan-Meier's survival algorithm estimated a mean overall survival of 236.05±11.56 months and a kidney survival of 240.77± 11.07 months. Kidney and overall survival were not significantly different among patients with different nephritis classes. Complications occurred in 12/40 (30.0%). Amenorrhea occurred in 20.7% of patients and was associated with higher cumulative doses of cyclophosphamide. Patients who achieved remission at 36 months or later had lower levels of proteinuria at 6 months (mean± SD=0.93 ±0.97g/24 h versus 2.60± 2.11g/24h, p =0.002) than non-responder patients. Conclusions: The data demonstrate that in the overall Caucasian population with lupus nephritis the combination of available therapeutic tools is effective and relatively well tolerated.

AB - Objective: To study efficacy and toxicity of treatments for nephritis in a series of consecutive lupus patients. Methods: The case records of 40 patients with lupus nephritis followed up in a single center between 1992 and 2011 (median duration=8.37 years) were retrieved to determine efficacy and toxicity of the treatments. Patients with class III/IV/V lupus nephritis were included. Results: Sustained responses were 21/40 (52.5%) at six months, 33/40 (82.5%) at 18 months and 30/40 (75.0%) at 36 months. Three deaths were observed after 18, 104 and 164 months of follow-up respectively, with one possibly associated with immunosuppression. Kidney survival was 100% at 18 months and 97.7% at 36 months. Kaplan-Meier's survival algorithm estimated a mean overall survival of 236.05±11.56 months and a kidney survival of 240.77± 11.07 months. Kidney and overall survival were not significantly different among patients with different nephritis classes. Complications occurred in 12/40 (30.0%). Amenorrhea occurred in 20.7% of patients and was associated with higher cumulative doses of cyclophosphamide. Patients who achieved remission at 36 months or later had lower levels of proteinuria at 6 months (mean± SD=0.93 ±0.97g/24 h versus 2.60± 2.11g/24h, p =0.002) than non-responder patients. Conclusions: The data demonstrate that in the overall Caucasian population with lupus nephritis the combination of available therapeutic tools is effective and relatively well tolerated.

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KW - Overall survival

KW - Renal function

KW - Systemic lupus erythematosus

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