Evidence map›Paper›PMID 30426311›Full record

Trial reportClinical rheumatology2019

Leflunomide versus cyclophosphamide in the induction treatment of proliferative lupus nephritis in Chinese patients: a randomized trial.

Minfang Zhang, Chaojun Qi, Yan Zha, Jian Chen, Ping Luo, Li Wang, Zhuxing Sun, Jianxin Wan, Changying Xing, Song Wang and 7 more

Open access · hybridAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 5 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 5 syntheses or guidelines pooled it, 42 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Effectiveness and safety of tripterygium glycosides tablet for lupus nephritis: a systematic review and Meta-analysis.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2022
    Pooled it
  5. Interventions for cutaneous disease in systemic lupus erythematosus.The Cochrane database of systematic reviews · 2021
    Pooled it
  6. Trial
  7. Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Review
  14. Lupus Nephritis in Children: Novel Perspectives.Medicina (Kaunas, Lithuania) · 2023
    Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. New developments in systemic lupus erythematosus.Rheumatology (Oxford, England) · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 13 institutions in 1 country.

Minfang ZhangDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Chaojun QiDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Yan ZhaDepartment of Nephrology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.
Jian ChenDepartment of Nephrology, Fuzhou General Hospital of Nanjing Military Command Area, Fuzhou, China.
Ping LuoDepartment of Nephrology, The Second Hospital of Jilin University, Jilin, China.
Li WangDepartment of Nephrology, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
Zhuxing SunDepartment of Nephrology, Wuxi People's Hospital, Wuxi, China.
Jianxin WanDepartment of Nephrology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Changying XingDepartment of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Song WangDepartment of Nephrology, Peking University Third Hospital, Peking, China.
Gengru JiangDepartment of Nephrology, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Mindan SunDepartment of Nephrology, First Hospital of Jilin University, Jilin, China.
Qinkai ChenDepartment of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Jianghua ChenDepartment of The Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Detian LiDepartment of Nephrology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Tianjun GuanDepartment of Nephrology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
Zhaohui NiDepartment of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. profnizh@126.com.
Renji Hospital · CNFuzhou General Hospital of Nanjing Military Command · CNChina Medical University · CNFujian Medical University · CNGuizhou Provincial People's Hospital · CNJiangsu Province Hospital · CNJilin University · CNNanchang University · CNPeking University · CNSecond Affiliated Hospital of Jilin University · CNWuxi People's Hospital · CNXinHua Hospital · CNZhongshan Hospital of Xiamen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesA prospective, multi-center, randomized controlled study was conducted to evaluate the efficacy and safety of a 24-week course low-dose leflunomide combined with prednisone in the induction treatment of proliferative lupus nephritis in Chinese patients.

methodPatients (n = 100) with biopsy-proved proliferative lupus nephritis were enrolled in this study. They were randomized into two groups and received either leflunomide or cyclophosphamide in conjunction with prednisone for 24 weeks. Leflunomide was given orally with a loading dose of 40 mg/day for 3 days followed by 20 mg/day. Intravenous cyclophosphamide was administered monthly at a dosage of 0.8-1.0 g. The primary efficacy outcome was the frequency of complete remission and partial remission at week 24. The secondary outcomes included changes of urinary protein excretion, serum albumin, complement 3, anti-dsDNA antibody level, and systemic lupus erythematosus disease activity index (SLEDAI) after 24-week therapy.

resultsOf 100 patients, 48 received leflunomide combined with prednisone and other 52 received cyclophosphamide with concomitant prednisone. There were no statistically significant differences between groups in complete remission rate and partial remission rate. At week 24, 23% of patients in the leflunomide group and 27% of patients in the cyclophosphamide group achieved complete remission (P = 0.64), while 56% of patients in the leflunomide group and 42% of patients in the cyclophosphamide group achieved partial remission at week 24 (P = 0.16). SLEDAI, serum albumin, complement 3, anti-dsDNA antibody level, and urinary protein excretion improved significantly in both groups. No significant difference was seen in the changes of clinical parameters after therapy between the two groups. There was no significant difference in side effects in both groups.

conclusionsCompared with cyclophosphamide, low-dose leflunomide in combination with prednisone showed both effectiveness and safety in the induction therapy of proliferative lupus nephritis in Chinese patients.

Indexed as

AdultAntibodies, AntinuclearChinaComplement C3CyclophosphamideDNADrug Therapy, CombinationFemaleGlucocorticoidsHumansImmunosuppressive AgentsInduction ChemotherapyLeflunomideLupus NephritisMaleMiddle AgedAntibodies, AntinuclearComplement C3CyclophosphamideDNAGlucocorticoidsImmunosuppressive AgentsLeflunomidePrednisoneSerum AlbuminEfficacyLeflunomideLupus nephritisProspective study

Identifiers

PMID30426311
OpenAlexW2901489384

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.