'Multi-target' immune therapy improves outcomes of severe lupus nephritis

Jul 02, 2008

A new treatment using a combination of drugs targeting different parts of the immune system improves the recovery rate for patients with severe lupus involving the kidneys, according to a report in the October Journal of the American Society of Nephrology (JASN).

"In our study, multi-target therapy is shown to be superior to traditional therapy for inducing complete remission of class V+IV lupus nephritis, with few side effects," comments Dr. Lei-Shi Li of the Research Institute of Nephrology of Jinling Hospital, Nanjing University School of Medicine in Nanjing, China.

The study included 40 patients with severe lupus nephritis. Lupus nephritis is inflammation of the kidneys occurring in patients with the immune system disease systemic lupus erythematosus (SLE). All patients had "class V+IV" disease, meaning widespread inflammation and decreasing function of the kidneys. "This is a severe form of lupus nephritis that is traditionally treated with a single immunosuppressant drug, but the efficacy is very poor," says Dr. Li. "We considered that, since the impact of severe SLE on the kidney involves various parts of the immune system, it is necessary to treat the different immune targets with a combination of immunosuppressant drugs."

One group of patients received this "multi-target" therapy, consisting of the immunosuppressant drugs tacrolimus and mycophenolate mofetil—commonly used as anti-rejection drugs in transplant patients—plus a steroid. The other group received standard treatment with a single immunosuppressant drug (cyclophosphamide).

The complete remission rate, with recovery of normal kidney function, was about four times higher among patients receiving the three-drug combination. "For patients receiving multi-target therapy, the complete remission rate reached 65 percent at nine months, versus only 15 percent under traditional therapy," says Dr. Li.

Some patients in both groups had partial remission, with some return of kidney function. Overall, 95 percent of patients in the multi-target therapy group had partial or complete remission, compared to 55 percent with single-drug therapy. The rate of most adverse effects was also lower with multi-target therapy.

Systemic lupus erythematosus is an autoimmune disorder, in which the immune system attacks healthy organs and tissues. By reducing immune system activity, treatment with immunosuppressant drugs has improved most outcomes for patients with SLE. However, class V+IV lupus nephritis continues to be a major problem—it has a poor response to traditional treatments and can lead to permanent kidney damage. "The prognosis is very poor, so it is important for us to develop a new regimen for the treatment of this type of lupus nephritis," says Dr. Li.

Using a combination of drugs that affect different immune targets, multi-target therapy improves the chances of remission for patients with severe lupus nephritis. "The therapeutic effect of our multi-target therapy is apparently superior to traditional therapy for inducing complete remission of Class V+IV lupus nephritis, and also bears good tolerance under relatively lower dosages," Dr. Li adds.

The authors stress that their study is only preliminary. The study includes a small group of patients from a single hospital, with a relatively short follow-up time. Larger randomized trials with longer follow-up are required.

Source: American Society of Nephrology

Explore further: Japanese firm behind Ebola drug says tests offer 'hope'

add to favorites email to friend print save as pdf

Related Stories

NY surveying banks on cyber security defenses

2 hours ago

(AP)—New York financial regulators are considering tougher cyber security requirements for banks to mandate more complex computer sign-ins and certifications from the contractors of their cyber defenses, the state's top ...

Study shows troubling rise in use of animals in experiments

17 minutes ago

Despite industry claims of reduced animal use as well as federal laws and policies aimed at reducing the use of animals, the number of animals used in leading U.S. laboratories increased a staggering 73 percent from 1997 ...

Life-saving train design is rarely used

3 hours ago

(AP)—Nearly a decade ago, the U.S. secretary of transportation stood at the site of a horrendous commuter train crash near downtown Los Angeles and called for the adoption of a new train car design that ...

Climate change may flatten famed surfing waves

3 hours ago

On a summer day in 1885, three Hawaiian princes surfed at the mouth of the San Lorenzo River on crudely constructed boards made from coastal redwoods, bringing the sport to the North American mainland.

Recommended for you

Image-guided treatment shown to break the migraine cycle

20 hours ago

An innovative interventional radiology treatment has been found to offer chronic migraine sufferers sustained relief of their headaches, according to research being presented at the Society of Interventional Radiology's Annual ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.