Abstract: FR-PO1109
The Short and Long Term Effect of Methylprednisolone Pulse Therapy for Lupus Nephritis Treated with Multi-target Therapy
Session Information
- Glomerular Diseases: Clinical, Outcomes, Trials - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Lan, Lan, Zhejiang University, Hangzhou, ZheJiang, China
- Lang, Xiabing, Zhejiang University, Hangzhou, ZheJiang, China
Background
Muti-target therapy was applied to the severe lupus nephritis, especially the patients with severe proteinuria. Methylprednisolon pulse therapy was used in the initial phase of induction therapy in some patients. We conducted this study to assess the short and long term effect of methylprednisolon pulse therapy on the lupus nephritis patients treated with muti-target therapy.
Methods
It's a retrospective study from 2007-2016, 43 patients diagnosed as lupus nephritis received muti-target therapy in our center, including prednisone combined with MMF and tacrolimus. 19 patients received methylprednisolon pulse therapy in the initial phase of induction therapy, 24 patients only received prednisone combined with MMF and tacrolimus. The dose of methylprednisolon pulse therapy was intravenous injection 500mg*3 days, following prednisone dose was 0.8-1.0mg/kg. The dose of MMF was 1.0-1.5g/d, the initial dose of tacrolimus was 0.05 mg/kg/d, the target trough levels was 3 to 8 ng/mL for 24 weeks, and then reduced to 3 to 6 ng/mL. In the patients combined with acute renal injury (AKI), we accessed the short term outcome by the decrease of serum creatinine in 1 and 3 month. Long term outcome variables included mean remission rate, average remission time.
Results
There was a significant difference in the decrease of creatinine between the two groups in 1 month (P=0.04). However, there was no significant difference in 3 month. In the 12 months follow up, 16 of 19 patients in the methylprednisolon pulse therapy group (84.2%) experienced remission (either complete or partial), and 12 of 19 patients (63.1%) experienced complete remission. In the group only receive muti-target therapy, 20 of 24 (83.3%) patients experienced remission, and 13 of 24 patients (54.2%) experienced complete remission. There were no significant difference in remission rate and remission time between the two groups (p=0.93 p=0.87). We also did not found significant difference in the serum creatinine and UP/Cr in 3, 6, 12month.
Conclusion
Methylprednisolon pulse therapy seemed had no significant effect on the long-term prognosis of lupus nephritis treated with muti-target therapy, but maybe it had better effect on the recovery of AKI patients.