A comparison between 9-month versus 6-month cyclophosphamide induction chemotherapy in the management of lupus nephritis in a government tertiary pediatric hospital in the Philippines.
- Author:
Zarah Marie Zamora-Tan
1
,
2
;
Mihnea Ellis Guanzon
1
,
2
;
Christine Bernal
1
,
2
;
Maria Rosario Cruz
1
,
2
Author Information
- Publication Type:Journal Article
- Keywords: Iv Cyclophosphamide; End-stage Renal Disease (esrd); Intravenous Cyclophosphamide (ivcy); Proliferate Lupus Nephritis
- MeSH: Human; Lupus Erythematosus, Systemic; Cyclophosphamide; Lupus Nephritis; Pediatrics; Induction Chemotherapy; Lupus Erythematosus, Systemic
- From: The Philippine Children’s Medical Center Journal 2017;13(1):80-90
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND: Lupus nephritis is very common complications in SLE, with clinical symptoms of renal involvement occurring in 30%-70% of patients. Outcomes in children with proliferative lupus nephritis (PLN) show 9-15% progress to end-stage renal disease (ESRD) at 5 years.
OBJECTIVES: This study compared the outcome of children and adolescent patients with lupus nephritis treated with 9 month versus 6 month induction of cyclophosphamide therapy. Renal frequency and adverse effects of IV cyclophosphamide during and after induction therapy were described and determined.
DESIGN: Retrospective Cohort Study
SETTING: Tertiary Hospital
METHODS: Retrospective cohort study comparing 6 and 9 month protocol of IV cyclophosphamide for lupus nephritis were conducted in a government tertiary pediatric hospital in the Philippines. A total of 39 patients with lupus nephritis were gathered, 23 patients underwent 6 months and 16 patients underwent 9 months protocol.
RESULTS: The comparison of two protocols in the administration of intravenous cyclophosphamide (IVCY) did not show significant difference between the two in terms of changes in GFR levels, but some evidence of a greater percent increase from baseline with the 6 months protocol post treatment were observed. Among 39 subjects, creatinine, albumin and urinalysis profile did not also differ between the two groups and levels within each group changed insignificantly over time up to 24 months. Proportion of subjects with renal flare ups, adverse effects and who expired during the study period were also essentially similar between the two groups.
CONCLUSION: IV Cyclophosphamide seems efficacious if given at the very beginning of the flare and at the start after patient was diagnosed with lupus nephritis. No statistically difference between the duration of the protocol. Renal flare ups and adverse effects of cyclophosphamide such as nausea, vomiting and headache were observed similarly between two protocols. Diligent follow up is needed for further studies and specificity of the results.
- Full text:A COMPARISON BETWEEN 9 MONTH VERSUS 6 MONTH.pdf
