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The safety of pharmacological treatment options for lupus nephritis

Velo-García, A; Ntatsaki, E; Isenberg, D; (2016) The safety of pharmacological treatment options for lupus nephritis. Expert Opinion on Drug Safety , 15 (8) pp. 1041-1054. 10.1080/14740338.2016.1182496. Green open access

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Abstract

INTRODUCTION: The management of lupus nephritis (LN) has changed significantly over the last 10 years due to emerging evidence from large randomised clinical trials that produced good quality data and guided the formulation of two key concepts: the induction of remission and the maintenance phase of immunosuppressive therapy. Areas covered: Optimizing cyclophosphamide and glucocorticoid regimens and the introduction of mycophenolate mofetil for proliferative and membranous LN has been pivotal. Nevertheless, concerns remain about treatment toxicity especially long term glucocorticoid use and exposure to cumulative cyclophosphamide doses. Here we discuss the conventional and newer pharmacological options for managing LN focusing on drug safety and toxicity issues. Expert opinion: The need for effective and less toxic treatments led to the development of the role of targeted biologic therapies in LN. However, evidence from the initial randomized controlled trials has been disappointing, although this reflects inadequate trial design rather than true lack of efficacy.

Type: Article
Title: The safety of pharmacological treatment options for lupus nephritis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/14740338.2016.1182496
Publisher version: http://dx.doi.org/10.1080/14740338.2016.1182496
Language: English
Additional information: Copyright © 2016 Informa UK Limited, trading as Taylor & Francis Group. All rights reserved. This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Opinion on Drug Safety on 13.05.2016, available online: http://www.tandfonline.com/10.1080/14740338.2016.1182496
Keywords: Safety, biologics, cyclophosphamide, lupus nephritis, treatment
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School
URI: http://discovery.ucl.ac.uk/id/eprint/1502233
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