The question: In people with lupus, the immune system goes awry and turns on the body. When it attacks the kidneys, a condition known as lupus nephritis, a cancer drug often is used as treatment. Might an immunosuppressant offer comparable treatment without the nausea, hair loss and infertility risks of cancer drugs?
This study: It randomly assigned 370 people with lupus nephritis to be given monthly intravenous infusions of the cancer drug cyclophosphamide (Cytoxan, Neosar) or to take mycophenolate mofetil (CellCept), an immunosuppressant, by tablet twice a day. All participants also took prednisone. After six months, 56 percent of those taking the immunosuppressant and 53 percent of the group taking the cancer drug had responded positively to the treatment, indicated by kidney function tests; 15 people taking the immunosuppressant and 16 being given the cancer drug were deemed in complete remission.
Who may be affected? People with lupus, about a third of whom develop kidney disease. In many people, lupus nephritis is mild and intermittent. In others, the disease progresses and can lead to loss of kidney function.
Caveats: Longer-term risks and effectiveness were not evaluated. About two-thirds of the participants had infections or gastrointestinal side effects. The study was funded by Aspreva Pharmaceuticals, which makes CellCept.
Find this study: May issue of the Journal of the American Society of Nephrology.
Learn more: www.kidney.niddk.nih.gov and www.lupus.org.
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