Austin HA, Vaughan EM, Boumpas DT, Balow GE
Randomized trial fo pulse cyclophosphamide and prednisone vs.
prednisonealone in idiopathic membranous nepropathy
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1327 1996
In a randomized study of patients with idiopathic membranous GN, Austin and
his colleagues at the NIH studied the
effectiveness of a one year course of IV cyclophosphamide every other month
with prednisone qod in 17 patients vs. prednisone alone in 14 patients.
The
mean GFR was 65 ml/minute measured by Tc-DTPA clearance, and mean 24-hour
protein excretion was 10 gm/day. There was improvement in GFR in 73% of
patients with values < 60 ml/minute and urine protein decreased by more
than 50% in 55% of patients with urine protein greater than 8 gm/day.
However, only 20% of patients achieved partial remission and there was no
evidence that IV cyclophosphamide plus prednisone was more effective than
prednisone alone.
Comment: This represents another study that suggests
cyclophosphamide has a limited, if any, role in the treatment of idiopathic
membranous GN.
(N. Kevin Krane, M.D., Tulane University)
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Am Soc Nephrol
Proteinuria/Hematuria :
Membranous GN