In another recent study, multitarget therapy of tacrolimus, MMF and steroid was compared with IV Cytoxan and steroid as induction therapy. After 24 weeks, 83% of those in the multitarget group achieved a response, compared with 45% in the IV Cytoxan group.4 Both of those, she noted, don’t have sufficient follow-up to assess relapse risk.
MLN is important to treat, Dr. Ramsey-Goldman said, because of the serious risks involved. Up to 20% of patients develop chronic kidney disease, and end-stage renal disease develops in 8% to 12% of patients after seven to 10 years. Some 14% of patients have end-stage renal disease or die by five years, and 28% in 10 years.
These figures demonstrate the need for prompt and effective treatment, she said.
Thomas R. Collins is a freelance medical writer based in Florida.
References
- Swan JT, Riche DM, Riche KD, et al. Systematic review and meta-analysis of immunosuppressant therapy clinical trials in membranous lupus nephritis. J Investig Med. 2011 Feb;59(2):246–258.
- Austin HA 3rd, Illei GG, Braun MJ, et al. Randomized, controlled trial of prednisone, cyclophosphamide, and cyclosporine in lupus membranous nephropathy. J Am Soc Nephrol. 2009 Apr;20(4):901–911.
- Mok CC, Ying KY, Yim CW, et al. Tacrolimus versus mycophenolate mofetil for induction therapy of lupus nephritis: A randomised controlled trial and long-term follow-up. Ann Rheum Dis. 2014 Dec 30; pii: annrheumdis-2014-206456.
- Liu Z, Zhang H, Liu Z, et al. Multitarget therapy for induction treatment of lupus nephritis: A randomized trial. Ann Intern Med. 2015 Jan 6;162(1):18–26.
