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Title: Multitarget Immune Therapy Improves Outcomes of Severe Lupus Nephritis
URL: http://www.pslgroup.com/dg/224C3E.htm
Doctor's Guide
July 2, 2008

Washington, DC -- July 2, 2008 -- A new treatment using a combination of drugs targeting different parts of the immune system improves the recovery rate for patients with severe lupus involving the kidneys, according to a study in the Journal of the American Society of Nephrology.

"In our study, multitarget therapy is shown to be superior to traditional therapy for inducing complete remission of class V+IV lupus nephritis, with few side effects," said lead author Lei-Shi Li, MD, Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.

"We considered that, since the impact of severe SLE [systemic lupus erythematosus] on the kidney involves various parts of the immune system, it is necessary to treat the different immune targets with a combination of immunosuppressant drugs."

The study included 40 patients with severe lupus nephritis (class V+IV). Patients were divided into 2 groups. The first group received the multitarget therapy, consisting of tacrolimus, mycophenolate mofetil, plus a steroid. The other group received standard, single-drug, treatment with cyclophosphamide.

The complete remission rate, with recovery of normal kidney function, was about 4 times higher among patients receiving the 3-drug combination. "For patients receiving multitarget therapy, the complete remission rate reached 65% at 9 months, versus only 15% under traditional therapy," said Dr. Li.

Some patients in both groups had partial remission, with some return of kidney function. Overall, 95% of patients in the multitarget therapy group had partial or complete remission, compared with 55% of patients in the single-drug therapy group. The rate of most adverse effects was also lower with multitarget therapy.

The authors stress that their study is only preliminary. The study includes a small group of patients from a single hospital, with a relatively short follow-up time. Larger randomised trials with longer follow-up are required.

SOURCE: American Society of Nephrology

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