INTRAVENOUS PULSE CYCLOPHOSPHAMIDE IN THE TREATMENT OF TYPE-IV LUPUS NEPHRITIS

A retrospective study compared two groups with type IV lupus nephritis with very similar activity and chronicity indices on renal biopsy. On e group was treated with intermittent pulse cyclophosphamide (IPC), an d the other was not. The IPC group demonstrated a greater decrease in serum creatinine at 6 months, 12 months and most recent follow-up inte rvals (p < 0.01, p < 0.05, p < 0.001). Reduction in proteinuria was si milar in the two groups. Two of eight in the no-IPC group progressed t o ESRD while only one of twelve in the IPC group developed ESRD. The f indings suggest that IPC preserves renal function in Type IV nephritis . Furthermore it is suggested that a lower cumulative dosage than prev iously reported may reduce toxicity without a significant loss of effi cacy.