ArticlePediatric nephrology (Berlin, Germany)2010
The use of low-dose cyclophosphamide followed by AZA/MMF treatment in childhood lupus nephritis.
Article in Pediatric nephrology (Berlin, Germany), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 29 citations in OpenAlex.
- Pathogenesis, Treatment Advances, and Renal Outcomes in Childhood-Onset Lupus Nephritis.Clinical pediatrics · 2026Review
- Expert collaborative evidence-based consensus for childhood lupus nephritis diagnosis and treatment: unifying clinical approach in Saudi Arabia.Pediatric rheumatology online journal · 2026Article
- Interdisciplinary Clinical Practice Guidelines for patient-centred management of juvenile-onset systemic lupus erythematosus.EULAR rheumatology open · 2025Article
- Do we really need cyclophosphamide for lupus nephritis?Pediatric nephrology (Berlin, Germany) · 2024Article
- Renal disease in pediatric rheumatology.Current opinion in rheumatology · 2024Review
- Renal Response Outcomes of the EuroLupus and National Institutes of Health Cyclophosphamide Dosing Regimens in Childhood-Onset Proliferative Lupus Nephritis.Arthritis & rheumatology (Hoboken, N.J.) · 2024Article
- High- and low-dose cyclophosphamide in Egyptian lupus nephritis patients: a multicenter retrospective analysis.Zeitschrift fur Rheumatologie · 2024Article
- Lupus Nephritis in Children: Novel Perspectives.Medicina (Kaunas, Lithuania) · 2023Review
- Childhood Lupus--Diagnosis and Management.Indian journal of pediatrics · 2016Review
- A treatment algorithm for children with lupus nephritis to prevent developing renal failure.International journal of preventive medicine · 2014Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cyclophosphamide (CYC) has been the landmark in the treatment of lupus nephritis. However, long-term treatment with CYC is associated with significant side effects. We aimed to evaluate the efficacy of short-term intravenous (IV) CYC treatment as a remission induction treatment followed by azathioprine (AZA) or mycophenolate mofetil (MMF) as a maintenance treatment. Twenty patients (18 girls) with biopsy-proven class III (5) and IV (15) lupus nephritis were included in to the study. Detailed clinical and laboratory data and patient outcomes were evaluated. All patients received three methylprednisolone (MP) IV pulses, followed by oral prednisone 0.5-1 mg/kg per day and one IV pulse of CYC per month for 6 months. Azathioprine was started as a remission-maintaining treatment. In ten of 20 patients, treatment was switched to MMF. The mean age at the time of diagnosis was 16.11 +/- 3.49 years, and the mean duration of follow-up was 49.6 +/- 27 months. Fourteen patients (70%) had complete remission, three (15%) had partial remission, one (5%) continued to have active disease, and two (10%) progressed to end-stage renal disease. Nine of the patients (45%) with complete remission had received AZA, and switching to MMF increased complete remission rate (additional five patients; 25%). In conclusion, short-term (6-month) IV bolus CYC treatment followed by AZA is a safe and effective treatment in children with severe lupus nephritis, and using MMF increases remission rate in resistant cases.
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