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Friday, August 15, 2008

New immune therapy gives hope to those with severe lupus nephritis

Lupus nephritis is an inflammation of the kidneys caused by lupus, otherwise known as systemic lupus erythematosus (SLE), a disease of the immune system. Marked by high blood pressure, dark urine, weight gain and swelling around the ankles, legs, fingers and eyes, the causes of the disease are unknown and treatments are varied. Severe lupus nephritis is marked by extensive inflammation and decreasing function of the kidneys.

A new study has found that a multi-target therapy combining drugs that target different parts of the immune system may be a superior form of therapy for inducing complete remission of severe lupus nephritis.

The study included 40 patients with “class V+IV” of the disease, meaning severe lupus nephritis. The disease is usually treated with a single immunosuppressant drug, but the study targeted different parts of the immune system with the immunosuppressant drugs tacrolimus and mycophenolate mofetil, in addition to a steroid. One group received the multi-targeted therapy, while the other group received the standard immunosuppressant, cyclophosphamide.

What they found was almost stunning: the remission rate was nearly four times higher among patients receiving the three-drug multi-target and at nine months the rate reached 65 percent, as opposed to 15 percent in those receiving the standard treatment. Since some patients in each group had partial remission, this skyrocketed the rate of the multi-target therapy to 95 percent for full or partial remission, while the standard group weighed in at 55 percent. They also found that adverse effects were lower in the multi-target group.

This study has infused many with hope, but since the study was small and all patients were from a single hospital, there will need to be larger, random trials in the future to determine if multi-targeted therapy can replace standard therapy and increase chances of remission in the future.








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