Low-dose VS High-dose IV Cyclophosphamide for Proliferative LN in Children
Status:
Terminated
Trial end date:
2019-05-01
Target enrollment:
Participant gender:
Summary
Proliferative lupus nephritis (LN)is the predominant cause of morbidity and mortality in
juvenile Systemic Lupus Erythematosus (SLE). Induction therapy with high-dose intravenous
cyclophosphamide can improve renal outcomes, but considerably associated with infection.
Although severe infection is the significant complication related to poorer prognosis for
juvenile SLE patients in Asia, cyclophosphamide is still commonly used as the drug of choice
for severe lupus nephritis. Euro-Lupus Nephritis Trial demonstrated low-dose intravenous
cyclophosphamide regimen followed by azathioprine achieved good clinical results comparable
with obtained high-dose regimen. There was lower number of severe infection episodes, but no
significant difference. Recent studies applied low dose of cyclophosphamide (500 mg/m2/dose
or 500 mg/dose)in young patients and showed good renal response. Low-dose intravenous
cyclophosphamide regimen might promote non-inferior renal remission whereas decrease risk of
serious infection and improve overall patient outcomes.