Long term efficacy of high-dose intravenous methylprednisolone pulses in active lupus nephritis. A 21-month prospective study.

Abstract

The efficacy of a single course of three high dose intravenous (i.v.) methylprednisolone (MP) pulses followed by low dose oral prednisone (PRED) was assessed in a group of patients with active lupus nephritis (LN). At 21 months after such therapeutic regimen in 10 out of 12 patients a complete clinical remission was found, in one patient a partial response with persistent moderate renal failure occurred, while one patient was refractory even to the additional administration of cyclophosphamide. The statistical analysis of repeated measures of a series of biological markers of LN, monitored over the course of the study, evidenced a significant improvement of serum creatinine (p < 0.05), C3 and C4 complement components (p < 0.05), 24-hour proteinuria (p < 0.02) and ESR values (p < 0.05). Moreover, a progressive and significant reduction of mean daily PRED dosage was reported (p < 0.05). We conclude that i.v. MP pulse therapy may exert a substantial long-term control of active LN and may induce steroid-sparing effects.

• Authors: M Bertoni, F Brugnolo, E Bertoni, M Salvadori, S Romagnani, L Emmi
• Journal: Scandinavian journal of rheumatology (Scand J Rheumatol) Vol. 23 Issue 2 Pg. 82-6 ( 1994) ISSN: 0300-9742 [Print] England
• PMID: 8165443 (Publication Type: Journal Article)

Chemical References

• Complement C3
• Complement C4
• Creatinine
• Prednisone
• Methylprednisolone

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Complement C3 (analysis)
• Complement C4 (analysis)
• Creatinine (blood)
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Female
• Humans
• Injections, Intravenous
• Lupus Nephritis (blood, drug therapy)
• Male
• Methylprednisolone (administration & dosage, therapeutic use)
• Middle Aged
• Prednisone (administration & dosage, therapeutic use)
• Prospective Studies
• Pulsatile Flow
• Time Factors
• Treatment Outcome