Prospective study of low-dose cyclosporine A in patients with refractory lupus nephritis

Hiroe Ogawa, Hideto Kameda, Hayato Nagasawa, Naoya Sekiguchi, Hirofumi Takei, Kensei Tsuzaka, Koichi Amano, Tsutomu Takeuchi

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30 Citations (Scopus)

Abstract

We evaluated the efficacy and safety of low-dose cyclosporine A (CsA) in patients with refractory lupus nephritis. Nine patients with systemic lupus erythematosus who had lupus nephritis resistant to previous treatment with glucocorticoids and immunosuppressants other than CsA were enrolled in a prospective, open-label study. All patients initially received 2.5 mg/kg per day of CsA; the dosage was adjusted to reach a blood trough level of 80-150ng/ml. The urinary protein concentration decreased significantly 2 weeks after the initiation of treatment. After 30 weeks of CsA treatment, the mean urinary protein concentration was more than 50% lower than the baseline value, and urinary casts had decreased significantly. There were no significant changes in the levels of serum creatinine, serum anti-double-stranded DNA antibodies, or CH50 during any part of the study. The dose of glucocorticoids was significantly tapered by approximately 50%, without any disease flare. Hypertension developed in one patient, but was controlled with antihypertensive agents. Our results suggest that low-dose CsA therapy is an effective and less toxic alternative to conventional cyclophosphamide therapy for the management of refractory lupus nephritis.

Original languageEnglish
Pages (from-to)92-97
Number of pages6
JournalModern rheumatology
Volume17
Issue number2
DOIs
Publication statusPublished - 2007 Apr 1
Externally publishedYes

Keywords

  • Cyclosporine A
  • Immunosuppressivedrugs
  • Lupusnephritis
  • Systemiclupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

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    Ogawa, H., Kameda, H., Nagasawa, H., Sekiguchi, N., Takei, H., Tsuzaka, K., Amano, K., & Takeuchi, T. (2007). Prospective study of low-dose cyclosporine A in patients with refractory lupus nephritis. Modern rheumatology, 17(2), 92-97. https://doi.org/10.1007/s10165-006-0545-8