关键词: 狼疮性肾炎, 多靶点疗法, 疗效

Abstract:

To further evaluate the long-term efficacy and safety of multi-target therapy (MT) as continuous induction and maintenance therapy for Class IV+V LN. Methodology：Eighty patients with biopsy-proved Class IV+V LN were included in this study. They were randomly assigned to MT group (n=40, MT inducing remission followed by MT maintenance) and IVCY-AZA group (n=40, IVCY inducing remission followed by AZA maintenance), both in combination with prednisolone. The total duration of observation was 24 months. The primary end point had complete remission, and the secondary end point had partial remission, renal relapse, and adverse effects. Results：36 patients in MT group and 24 patients in IVCY-AZA group responded favorably (complete or partial remission) to induction treatment (P <0.01). In MT group, the complete-remission rate at 6 mo (45% vs 12.5%, P < 0.01) and 24 mo (80% vs 47.5%, P < 0.01) were significantly higher than those in IVCY-AZA group. The rate of renal relapse and renal relapse-free survival were similar between the two groups (8.3% vs 4.8%, P>0.05). Infections were noted in more than 20% of patients in both groups (P >0.05). Alopecia, nausea and vomiting were more common during IVCY induction (P<0.05), conversely, new onset hypertension occurred only in patients with MT induction (P<0.05). During maintenance, both groups had favorable safety profile, with 10% and 15% patients of leucopenia episode (P >0.05). Conclusions：MT therapy was an effective induction and maintenance treatment for patients with Class IV+V LN, with higher response rate and favorable tolerability. 

Key words: lupus nephritis, multi-target therapy, curative effect