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Publication Detail
The safety of pharmacological treatment options for lupus nephritis.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Velo-García A, Ntatsaki E, Isenberg D
  • Publication date:
    13/05/2016
  • Pagination:
    1041, 1054
  • Journal:
    Expert opinion on drug safety
  • Volume:
    15
  • Issue:
    8
  • Medium:
    Print-Electronic
  • Print ISSN:
    1474-0338
  • Language:
    eng
  • Addresses:
    b Centre for Rheumatology, Division of Medicine , University College London , UK.
Abstract
The management of lupus nephritis (LN) has changed significantly over the last 10 years due to emerging evidence from large randomised clinical trials that produced good quality data and guided the formulation of two key concepts: the induction of remission and the maintenance phase of immunosuppressive therapy.Optimizing cyclophosphamide and glucocorticoid regimens and the introduction of mycophenolate mofetil for proliferative and membranous LN has been pivotal. Nevertheless, concerns remain about treatment toxicity especially long term glucocorticoid use and exposure to cumulative cyclophosphamide doses. Here we discuss the conventional and newer pharmacological options for managing LN focusing on drug safety and toxicity issues.The need for effective and less toxic treatments led to the development of the role of targeted biologic therapies in LN. However, evidence from the initial randomized controlled trials has been disappointing, although this reflects inadequate trial design rather than true lack of efficacy.
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