Lupus nephritis: Maintenance therapy for lupus nephritis-do we now have a plan?

Oliver Lenz, Ahmed A. Waheed, Abdur Baig, Alexander Pop, Gabriel Contreras

Research output: Contribution to journalReview article

13 Scopus citations

Abstract

Lupus nephritis (LN) increases the morbidity and mortality of patients with SLE. This review compares the randomized, controlled trials that examined various maintenance regimens available to treat LN. Currently, mycophenolate mofetil (MMF) and azathioprine (AZA) are the most popular therapeutic agents used for long-term maintenance of LN. Long-term maintenance with MMF is recommended as the first choice after achieving remission with cyclophosphamide or MMF induction. MMF is effective in consolidating remission and preventing relapse and CKD in patients of diverse races and ethnicities. Long-term maintenance with AZA is the recommended second choice, especially when patients develop intolerance of or contraindications to MMF. Azathioprine is particularly effective in consolidating remission and preventing relapse and CKD in patients who receive an induction regimen of cyclophosphamide. To date, there are no data on how rapidly maintenance therapies can be withdrawn; however, it is recommended that the immunosuppressive therapy be maintained indefinitely, unless it is contraindicated, in patients at high risk for progression to CKD.

Original languageEnglish (US)
Pages (from-to)162-171
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Volume8
Issue number1
DOIs
StatePublished - Jan 7 2013

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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