Evidence map›Paper›PMID 30488367›Full record

Trial reportClinical rheumatology2019

Combined immunosuppressive treatment (CIST) in lupus nephritis: a multicenter, randomized controlled study.

Yuan An, Yunshan Zhou, Liqi Bi, Bo Liu, Hong Wang, Jin Lin, Danyi Xu, Mei Wang, Jing Zhang, Yongfu Wang and 27 more

Abstract readMulticenter 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 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.0field-weighted citation impact, top 14% 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

8 citing papers in PubMed, 18 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Review
  4. Article
  5. Review
  6. Article
  7. Review
  8. Lupus nephritis: challenges and progress.Current opinion in rheumatology · 2019
    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

37 authors at 20 institutions in 1 country.

Yuan AnDepartment of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Yunshan ZhouDepartment of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Liqi BiDepartment of Rheumatology, China Japan Union Hospital, Jilin University, Changchun, China.
Bo LiuDepartment of Rheumatology, China Japan Union Hospital, Jilin University, Changchun, China.
Hong WangDepartment of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Jin LinDepartment of Rheumatology and Immunology, First Affiliated Hospital, Zhejing University, Hangzhou, China.
Danyi XuDepartment of Rheumatology and Immunology, First Affiliated Hospital, Zhejing University, Hangzhou, China.
Mei WangDepartment of Nephrology, Peking University People's Hospital, Beijing, China.
Jing ZhangDepartment of Nephrology, Peking University People's Hospital, Beijing, China.
Yongfu WangDepartment of Rheumatology, First Affiliated Hospital of Baotou Medical College, Baotou, China.
Yan AnDepartment of Rheumatology, First Affiliated Hospital of Baotou Medical College, Baotou, China.
Ping ZhuDepartment of Clinical Immunology, Fourth Military Medical University Xijing Hospital, Xi'an, China.
Ronghua XieDepartment of Clinical Immunology, Fourth Military Medical University Xijing Hospital, Xi'an, China.
Zhiyi ZhangDepartment of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Yifang MeiDepartment of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Xiangyuan LiuDepartment of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.
Xiaoli DengDepartment of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.
Zhongqiang YaoDepartment of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.
Zhuoli ZhangDepartment of Rheumatology and Immunology, Peking University First Hospital, Beijing, China.
Yu WangDepartment of Rheumatology and Immunology, Peking University First Hospital, Beijing, China.
Weiguo XiaoDepartment of Rheumatology and Immunology, First Affiliated Hospital of China Medical University, Shenyang, China.
Hui ShenDepartment of Rheumatology and Immunology, First Affiliated Hospital of China Medical University, Shenyang, China.
Xiuyan YangDepartment of Rheumatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Hanshi XuDepartment of Rheumatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Feng YuDepartment of Nephrology, Peking University First Hospital, Beijing, China.
Guochun WangDepartment of Rheumatology and Immunology, China-Japan Friendship Hospital, Beijing, China.
Xin LuDepartment of Rheumatology and Immunology, China-Japan Friendship Hospital, Beijing, China.
Yang LiDepartment of Rheumatology and Immunology, Second Clinical Hospital, Harbin Medical University, Harbin, China.
Yingnan LiDepartment of Rheumatology and Immunology, Second Clinical Hospital, Harbin Medical University, Harbin, China.
Xiaoxia ZuoDepartment of Rheumatology and Immunology, Xiangya Hospital Central South University, Changsha, China.
Yisha LiDepartment of Rheumatology and Immunology, Xiangya Hospital Central South University, Changsha, China.
Yi LiuDepartment of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
Yi ZhaoDepartment of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China.
Jianping GuoDepartment of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Lingyun SunDepartment of Rheumatology and Immunology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Minghui ZhaoDepartment of Nephrology, Peking University First Hospital, Beijing, China.
Zhanguo LiDepartment of Rheumatology and Immunology, Peking University People's Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China. zgli99@aliyun.com.
Peking University · CNHarbin Medical University · CNChina-Japan Friendship Hospital · CNFirst Affiliated Hospital Zhejiang University · CNJilin University · CNNanjing Drum Tower Hospital · CNPeking University People's Hospital · CNWest China Hospital of Sichuan University · CNAir Force Medical University · CNCentral South University · CNChina Medical University · CNFirst Affiliated Hospital of Harbin Medical University · CNFirst Hospital of China Medical University · CNPeking University First Hospital · CNPeking University Third Hospital · CNSecond Affiliated Hospital of Harbin Medical University · CNSun Yat-sen University · CNThe First Affiliated Hospital, Sun Yat-sen University · CNXiangya Hospital Central South University · CNXijing Hospital · CN

Funding

National Basic Research Program of China (973 program) 2014CB541901
6 · The paper itself

Abstract

objectivesThe standard strategy for treating lupus nephritis comprises glucocorticoids together with either intravenous cyclophosphamide or oral mycophenolate mofetil, but the low remission rate is still a challenge in practice. This study was aimed to seek higher remission rate of lupus nephritis using a combined strategy.

methodA 24-week trial was conducted in 17 rheumatology or nephrology centers in China. A total of 191 lupus nephritis patients were randomized to follow a combined immunosuppressive treatment (CIST) with intravenous cyclophosphamide, an oral immunosuppressive agent, namely mycophenolate mofetil, azathioprine or leflunomide, and hydroxychloroquine (n = 95), or receive intravenous cyclophosphamide alone (n = 96) for 24 weeks. Glucocorticoid was given to both groups. The primary end point was a complete remission with a most stringent standard as proteinuria < 150 mg per 24 h, normal urinary sediment, serum albumin, and renal function at 24 weeks. The secondary end point was treatment failure at 24 weeks.

resultsAt week 24, both the rate of complete remission (39.5%) and total response (87.2%) was higher in the combined group, compared with CYC group (20.8% and 68.8%, p < 0.05). The cumulative probability of complete remission was also higher in the combined group (p = 0.013). In addition, the combined treatment was superior to routine CYC with less treatment failure (12.8% vs.31.2%, p < 0.001). No difference was found between the incidences of severe adverse events in the two arms: 3.2% (3/95 combined group) vs.4.2% (4/96 CYC group).

conclusionTreatment with a combined immunosuppressive agent is superior to routine CYC only therapy in lupus nephritis.

Indexed as

AdultAzathioprineCyclophosphamideDrug Therapy, CombinationFemaleGlucocorticoidsHumansImmunosuppressive AgentsLeflunomideLupus NephritisMaleMiddle AgedMycophenolic AcidRemission InductionTreatment OutcomeYoung AdultAzathioprineCyclophosphamideGlucocorticoidsImmunosuppressive AgentsLeflunomideMycophenolic AcidImmunosuppressive agentsLupus nephritisRemission inducingSystemic lupus erythematosus

Identifiers

PMID30488367
OpenAlexW2902615416

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.