Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Jun 29;6(6):CD002922.
doi: 10.1002/14651858.CD002922.pub4.

Immunosuppressive treatment for proliferative lupus nephritis

David J Tunnicliffe  1 , Suetonia C Palmer, Lorna Henderson, Philip Masson, Jonathan C Craig, Allison Tong, Davinder Singh-Grewal, Robert S Flanc, Matthew A Roberts, Angela C Webster, Giovanni Fm Strippoli
Affiliations
Meta-Analysis

Immunosuppressive treatment for proliferative lupus nephritis

David J Tunnicliffe et al. Cochrane Database Syst Rev. .

Abstract

Background: Cyclophosphamide, in combination with corticosteroids, has been first-line treatment for inducing disease remission for proliferative lupus nephritis, reducing death at five years from over 50% in the 1950s and 1960s to less than 10% in recent years. Several treatment strategies designed to improve remission rates and minimise toxicity have become available. Treatments, including mycophenolate mofetil (MMF) and calcineurin inhibitors, alone and in combination, may have equivalent or improved rates of remission, lower toxicity (less alopecia and ovarian failure) and uncertain effects on death, end-stage kidney disease (ESKD) and infection. This is an update of a Cochrane review first published in 2004 and updated in 2012.

Objectives: Our objective was to assess the evidence and evaluate the benefits and harms of different immunosuppressive treatments in people with biopsy-proven lupus nephritis. The following questions relating to management of proliferative lupus nephritis were addressed: 1) Are new immunosuppressive agents superior to or as effective as cyclophosphamide plus corticosteroids? 2) Which agents, dosages, routes of administration and duration of therapy should be used? 3) Which toxicities occur with the different treatment regimens?

Search methods: We searched the Cochrane Kidney and Transplant Specialised Register up to 2 March 2018 with support from the Cochrane Information Specialist using search terms relevant to this review. Studies in the Specialised Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov.

Selection criteria: Randomised controlled trials (RCTs) and quasi-RCTs comparing any immunosuppressive treatment for biopsy-proven class III, IV, V+III and V+VI lupus nephritis in adult or paediatric patients were included.

Data collection and analysis: Data were abstracted and the risks of bias were assessed independently by two authors. Dichotomous outcomes were calculated as risk ratio (RR) and measures on continuous scales calculated as mean differences (MD) with 95% confidence intervals (CI). The primary outcomes were death (all causes) and complete disease remission for induction therapy and disease relapse for maintenance therapy. Evidence certainty was determined using GRADE.

Main results: In this review update, 26 new studies were identified, to include 74 studies involving 5175 participants overall. Twenty-nine studies included children under the age of 18 years with lupus nephritis, however only two studies exclusively examined the treatment of lupus nephritis in patients less than 18 years of age.Induction therapy Sixty-seven studies (4791 participants; median 12 months duration (range 2.5 to 48 months)) reported induction therapy. The effects of all treatment strategies on death (all causes) and ESKD were uncertain (very low certainty evidence) as this outcome occurred very infrequently. Compared with intravenous (IV) cyclophosphamide, MMF may have increased complete disease remission (RR 1.17, 95% CI 0.97 to 1.42; low certainty evidence), although the range of effects includes the possibility of little or no difference.Compared to IV cyclophosphamide, MMF is probably associated with decreased alopecia (RR 0.29, 95% CI 0.19 to 0.46; 170 less (129 less to 194 less) per 1000 people) (moderate certainty evidence), increased diarrhoea (RR 2.42, 95% CI 1.64 to 3.58; 142 more (64 more to 257 more) per 1000 people) (moderate certainty evidence) and may have made little or no difference to major infection (RR 1.02, 95% CI 0.67 to 1.54; 2 less (38 less to 62 more) per 1000 people) (low certainty evidence). It is uncertain if MMF decreased ovarian failure compared to IV cyclophosphamide because the certainty of the evidence was very low (RR 0.36, 95% CI 0.06 to 2.18; 26 less (39 less to 49 more) per 1000 people). Studies were not generally designed to measure ESKD.MMF combined with tacrolimus may have increased complete disease remission (RR 2.38, 95% CI 1.07 to 5.30; 336 more (17 to 1048 more) per 1000 people (low certainty evidence) compared with IV cyclophosphamide, however the effects on alopecia, diarrhoea, ovarian failure, and major infection remain uncertain. Compared to standard of care, the effects of biologics on most outcomes were uncertain because of low to very low certainty of evidence.Maintenance therapyNine studies (767 participants; median 30 months duration (range 6 to 63 months)) reported maintenance therapy. In maintenance therapy, disease relapse is probably increased with azathioprine compared with MMF (RR 1.75, 95% CI 1.20 to 2.55; 114 more (30 to 236 more) per 1000 people (moderate certainty evidence). Multiple other interventions were compared as maintenance therapy, but patient-outcome data were sparse leading to imprecise estimates.

Authors' conclusions: In this review update, studies assessing treatment for proliferative lupus nephritis were not designed to assess death (all causes) or ESKD. MMF may lead to increased complete disease remission compared with IV cyclophosphamide, with an acceptable adverse event profile, although evidence certainty was low and included the possibility of no difference. Calcineurin combined with lower dose MMF may improve induction of disease remission compared with IV cyclophosphamide, but the comparative safety profile of these therapies is uncertain. Azathioprine may increase disease relapse as maintenance therapy compared with MMF.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Study flow diagram. *Non‐RCTs have been deleted from this update
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Abedi 2007 {published data only}
    1. Abedi A, Nakhjavani MR, Gafari N, Argani H. Comparison between corticosteroid and mycophenolate mofetil and corticosteroid and cyclophosphamide in the treatment of lupus nephritis [abstract no: FO031]. Nephrology Dialysis Transplantation 2007;22(Suppl 6):vi14.
ACCESS 2014 {published data only}
    1. ACCESS Trial Group. Treatment of lupus nephritis with abatacept: the Abatacept and Cyclophosphamide Combination Efficacy and Safety Study.[Erratum appears in Arthritis Rheumatol. 2015 Feb;67(2):487 Note: Aranow, Cynthia [added]]. Arthritis & Rheumatology 2014;66(11):3096‐104. [MEDLINE: ] - PMC - PubMed
    1. Shidham GB, Birmingham DJ, Rovin B, Hebert LA. 24 hour protein: creatinine ration (24 PCR), not spot PCR (Spot PCR), should be used to monitor the treatment of severe lupus nephritis (LN): the experience of ACCESS [abstract no: FR‐PO604]. Journal of the American Society of Nephrology 2016;27(Abstract Suppl):501A.
    1. Shidham GB, Birmingham DJ, Rovin B, Hebert LA. Ability of spot urine protein/creatinine ratio (spot PCR) to correctly identify the proteinuria endpoints of complete remission (CR), partial remission (PR), and treatment failure (TF) as determined by 24 hour urine PCR (24 PCR): experience of abatacept and cyclophosphamide combination efficacy and safety study (ACCESS) [abstract no: TH‐PO764]. Journal of the American Society of Nephrology 2015;26(Abstract Suppl):265A.
    1. Wofsy D, Askanase A, Cagnoli PC, Chatham WW, Contreras G, Dall'Era M, et al. Treatment of lupus nephritis with abatacept plus low‐dose pulse cyclophosphamide followed by azathioprine (the Euro‐Lupus regimen): twenty‐four week data from a double‐blind controlled trial [abstract no: 884]. Arthritis & Rheumatology 2013;66(10 Suppl):S379‐80. [EMBASE: 71318364]
    1. Wofsy D, Hillson JL, Diamond B. Abatacept for lupus nephritis: alternative definitions of complete response support conflicting conclusions. Arthritis & Rheumatology 2012;64(11):3660‐5. [MEDLINE: ] - PubMed
ALMS 2007 {published and unpublished data}
    1. Appel GB, Contreras G, Dooley MA, Ginzler EM, Isenberg D, Jayne D, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. Journal of the American Society of Nephrology 2009;20(5):1103‐12. [MEDLINE: ] - PMC - PubMed
    1. Appel GB, Dooley MA, Ginzler EM, Isenberg D, Jayne D, Solomons N, et al. Mycophenolate mofetil compared with intravenous cyclophosphamide as induction therapy for lupus nephritis: Aspreva Lupus Management Study (ALMS) results [abstract no: SA‐FC057]. Journal of the American Society of Nephrology 2007;18(Abstracts):47A.
    1. Clancy RM, Ginzler EM, Kim M. Association of adiponectin and soluble endothelial protein C receptor (sEPCR) with longitudinal assessments in the induction phase of a randomized multicenter trial comparing mycophenolate mofetil and intravenous cyclophosphamide [abstract no: 263]. ACR/ARHP Annual Scientific Meeting; 2009 Oct 17‐21; Philadelphia (PA). 2009.
    1. Dall'Era M, Stone D, Levesque V, Cisternas M, Wofsy D. Identification of biomarkers that predict response to treatment of lupus nephritis with mycophenolate mofetil or pulse cyclophosphamide. Arthritis Care & Research 2011;63(3):351‐7. [MEDLINE: ] - PubMed
    1. Dooley MA, Appel GB, Ginzler EM, Isenberg D, Jayne D, Wofsy D, et al. Aspreva lupus management study (ALMS): maintenance results analysis by racial subgroup [abstract no: OP0168]. Annals of the Rheumatic Diseases 2011;70(Suppl 3):125.
APRIL‐LN 2012 {published data only}
    1. Ginzler EM, Wax S, Rajeswaran A, Copt S, Hillson J, Ramos E, et al. Atacicept in combination with MMF and corticosteroids in lupus nephritis: results of a prematurely terminated trial. Arthritis Research & Therapy 2012;14(1):R33. [MEDLINE: ] - PMC - PubMed
AURA‐LV 2016 {published data only}
    1. Dooley MA, Pendergraft WF, Ginzler EM, Olsen NJ, Tumlin J, Rovin B, et al. Speed of remission with the use of voclosporin, MMF and low dose steroids: results of a global lupus nephritis study [abstract no: 5L]. Arthritis & Rheumatology 2016;68(Suppl 10):4362‐3. [EMBASE: 613889173]
    1. Parikh SV, Pendergraft WF, Tumlin JA, Saxena R, Solomons N, Huizinga RB. Treatment of active lupus nephritis with voclosporin: 48 week data from the AURA‐LV study [abstract no: 4]. American Journal of Kidney Diseases 2017;69(5):A2.
    1. Pendergraft WF, Tumlin JA, Rovin B, Dooley MA, Jayne DR, Wofsy D, et al. AURA‐LV: successful treatment of active lupus nephritis with voclosporin [abstract no: HI‐OR05]. Journal of the American Society of Nephrology 2016;27(Abstract Suppl):2B.
Balletta 1992 {published data only}
    1. Balletta M, Sabella D, Magri P, Sepe V, Stanziale P, Luccio R, et al. Cyclosporin plus steroids versus steroids alone in the treatment of lupus nephritis. Contributions to Nephrology 1992;99:129‐30. [MEDLINE: ] - PubMed
Bao 2008 {published and unpublished data}
    1. Bao H, Liu ZH, Xie HL, Hu WX, Zhang HT, Li LS. Successful treatment of class V+IV lupus nephritis with multi‐target therapy. Journal of the American Society of Nephrology 2008;19(10):2001‐10. [MEDLINE: ] - PMC - PubMed
    1. Bao H, Xie HL, Zhang HT, Zhang X, Hu WX, Liu ZH, et al. Successful treatment of class V+IV lupus nephritis with multi‐target immunosuppressive therapy [abstract no: SA‐FC060]. Journal of the American Society of Nephrology 2007;18(Abstracts):48a.
Barron 1982 {published data only}
    1. Barron KS, Person DA, Brewer EJ Jr, Beale MG, Robson AM. Pulse methylprednisolone therapy in diffuse proliferative lupus nephritis. Journal of Pediatrics 1982;101(1):137‐41. [MEDLINE: ] - PubMed
Belmont 1995 {published data only}
    1. Belmont HM, Kitsis E, Skovron ML, McCullagh E, Abramson S. Misoprostol and prednisone treatment of lupus nephritis. American Journal of Therapeutics 1995;2(12):928‐32. [PUBMED: 11854810] - PubMed
BELONG 2013 {published data only}
    1. Mysler E, Spindler A, Guzman R, Renato B. Study design and baseline patient characteristics of BELONG, the randomized double‐blind, placebo‐controlled phase III trial of ocrelizumab, a humanized anti‐CD20 antibody, in lupus nephritis [abstract no: PO2.E20]. Lupus 2010;19(1 Suppl):156.
    1. Mysler EF, Spindler AJ, Guzman R, Bijl M, Jayne D, Furie RA, et al. Efficacy and safety of ocrelizumab in active proliferative lupus nephritis: results from a randomized, double‐blind, phase III study. Arthritis & Rheumatism 2013;65(9):2368‐79. [MEDLINE: ] - PubMed
    1. Mysler EF, Spindler AJ, Guzman R, Bijl M, Jayne D, Furie RA, et al. Efficacy and safety of ocrelizumab, a humanized antiCD20 antibody, in patients with active proliferative lupus nephritis (LN): results from the randomized, double‐blind phase III BELONG Study [abstract]. Arthritis & Rheumatism 2010;62(Suppl 10):1455. [EMBASE: 70380848]
Boedigheimer 2017 {published data only}
    1. Boedigheimer MJ, Martin DA, Amoura Z, Sanchez‐Guerrero J, Romero‐Diaz J, Kivitz A, et al. Safety, pharmacokinetics and pharmacodynamics of AMG 811, an anti‐interferon‐gamma monoclonal antibody, in SLE subjects without or with lupus nephritis. Lupus Science & Medicine 2017;4(1):e000226. [MEDLINE: ] - PMC - PubMed
Boletis 1999 {published data only}
    1. Boletis JN, Boki C, Michael S, Stamatiadis DN, Nakopoulou L, Moutsopoulos C. Comparative study of pulse treatment with cyclophosphamide or immunoglobulin to sustain the remission of lupus nephritis [abstract]. Journal of the American Society of Nephrology 1998;9(Program & Abstracts):140A‐1A.
    1. Boletis JN, Ioannidis JP, Boki KA, Moutsopoulos HM. Intravenous immunoglobulin compared with cyclophosphamide for proliferative lupus nephritis. Lancet 1999;354(9178):569‐70. [MEDLINE: ] - PubMed
Boumpas 1992 {published data only}
    1. Austin HA, Fessler BJ, Boumpas DT, Vaughan EM, Klippel JH, Balow JE. Prognostic indicators supporting use of short courses of pulse immunosuppression for severe lupus nephritis (LN) [abstract no: 130]. Journal of the American Society of Nephrology 1995;6(3):411.
    1. Boumpas DT, Austin HA, Vaughn EM, Klippel JH, Steinberg AD, Yarboro CH, et al. Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. Lancet 1992;340(8822):741‐5. [MEDLINE: ] - PubMed
    1. Illei GG, Takada K, Parkin D, Austin HA, Crane M, Yarboro CH, et al. Renal flares are common in patients with severe proliferative lupus nephritis treated with pulse immunosuppressive therapy: long‐term followup of a cohort of 145 patients participating in randomized controlled studies. Arthritis & Rheumatism 2002;46(4):995‐1002. [MEDLINE: ] - PubMed
Cade 1973 {published data only}
    1. Cade R, Spooner G, Schlein E, Pickering M, DeQuesada A, Holcomb A, et al. Comparison of azathioprine, prednisone, and heparin alone or combined in treating lupus nephritis. Nephron 1973;10(1):37‐56. [MEDLINE: ] - PubMed
Chan 2000 {published data only}
    1. Chan T, Wong W, Lau C, Tsang EW, Ji Y, Mok M, et al. Prolonged follow‐up of patients with diffuse proliferative lupus nephritis (DPLN) treated with prednisolone and mycophenolate mofetil (MMF) [abstract no: A1010]. Journal of the American Society of Nephrology 2001;12(Program & Abstracts):195A.
    1. Chan TM. Mycophenolate mofetil in the treatment of lupus nephritis: 7 years on. Lupus 2008;17(7):617‐21. [MEDLINE: ] - PubMed
    1. Chan TM, Li FK, Tang CS, Wong RW, Fang GX, Ji YL, et al. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. Hong Kong‐Guangzhou Nephrology Study Group. New England Journal of Medicine 2000;343(16):1156‐62. [MEDLINE: ] - PubMed
    1. Chan TM, Tse KC, Tang CS, Mok MY, Li FK, Hong Kong Nephrology Study Group. Long‐term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis. Journal of the American Society of Nephrology 2005;16(4):1076‐84. [MEDLINE: ] - PubMed
    1. Karassa FB, Isenberg DA. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. New England Journal of Medicine 2001;344(5):382‐3. [MEDLINE: ] - PubMed
Chen 2011 {published data only}
    1. Chen W, Liu Q, Chen W, Fu P, Liao Y, Zhang J, et al. A prospective multicenter randomized trial of treatment of active lupus nephritis with tacrolimus versus cyclophosphamide/azathioprine in Chinese adults [abstract no: SU248]. World Congress of Nephrology; 2009 May 22‐26; Milan (Italy). 2009.
    1. Chen W, Liu Q, Chen W, Tang X, Fu P, Liu F, et al. Outcomes of maintenance therapy with tacrolimus versus azathioprine for active lupus nephritis: a multicenter randomized clinical trial. Lupus 2012;21(9):944‐52. [MEDLINE: ] - PubMed
    1. Chen W, Tang X, Liu Q, Chen W, Fu P, Liu F, et al. Short‐term outcomes of induction therapy with tacrolimus versus cyclophosphamide for active lupus nephritis: a multicenter randomized clinical trial. American Journal of Kidney Diseases 2011;57(2):235‐44. [MEDLINE: ] - PubMed
Clark 1981 {published data only}
    1. Clark WF, Lindsay RM, Cattran DC, Chodirker WB, Barnes CC, Linton AL. Monthly plasmapheresis for systemic lupus erythematosus with diffuse proliferative glomerulonephritis: a pilot study. Canadian Medical Association Journal 1981;125(2):171‐4. [MEDLINE: ] - PMC - PubMed
    1. Clark WF, Lindsay RM, Chodirker WB, Cattran D, Linton AL. Elective plasmapheresis in S.L.E. nephritis: pilot for a controlled prospective study [abstract]. Kidney International 1979;16(6):928.
Clark 1984 {published data only}
    1. Clark WF, Balfe JW, Cattran DC. Long‐term plasma exchange in patients with systemic lupus erythematosus and diffuse proliferative glomerulonephritis. Plasma Therapy & Transfusion Technology 1984;5(3):353‐60. [EMBASE: 14000064]
    1. Clark WF, Cattran D, Balfe JW, Williams W, Lindsay RM, Linton AL. Chronic plasma exchange in SLE nephritis [abstract]. Kidney International 1983;24(3):424.
    1. Clark WF, Cattran DC, Balfe JW, Williams W, Lindsay RM, Linton AL. Chronic plasma exchange in systemic lupus erythematosus nephritis. Proceedings of the European Dialysis & Transplant Association 1983;20:629‐35. [MEDLINE: ] - PubMed
    1. Clark WF, Williams W, Cattran DC, Balfe JW, Chodirker WB, Koval JJ, et al. A controlled trial of chronic plasma exchange therapy in S.L.E. nephritis [abstract]. Kidney International 1984;25(1):161.
    1. Clark WF, Williams W, Cattran DC, Chodirker WB, Koval JJ, Lindsay RM, et al. Controlled trial of chronic plasma exchange therapy in SLE nephritis [abstract]. Kidney International 1982;21(1):147.
Contreras 2004 {published and unpublished data}
    1. Contreras G, Pardo V, Leclercq B, Gomez E, Reich J, O'Nan P, et al. Maintenance therapy for proliferative forms of lupus nephritis: a randomized clinical trial comparing quarterly intravenous cyclophosphamide (IVCY) versus oral mycophenolate mofetil (MMF) or azathioprine (AZA) [abstract no: F‐FC069]. Journal of the American Society of Nephrology 2002;13(Sept Program & Abstracts):15A.
    1. Contreras G, Pardo V, Leclercq B, Lenz O, ONan P, Tozman E, et al. Lupus nephritis: sequential therapy with short‐term intravenous cyclophosphamide followed by maintenance oral mycophenolate mofetil or oral azathioprine is more efficacious and safer than long‐term intravenous cyclophosphamide [abstract no: SA‐FC173]. Journal of the American Society of Nephrology 2003;14(Nov):38A.
    1. Contreras G, Pardo V, Leclercq B, Lenz O, Tozman E, O'Nan P, et al. Sequential therapies for proliferative lupus nephritis. New England Journal of Medicine 2004;350(10):971‐80. [MEDLINE: ] - PubMed
    1. Contreras G, Roth D, Berho M, Perez G, Gomez E, Acosta M, et al. Immunosupressive therapy for proliferative lupus nephritis: preliminary report of a prospective, randomized clinical trial with mycophenolate mofetil (MMF) [abstract]. Journal of the American Society of Nephrology 1999;10(Program & Abstracts):99A.
    1. Contreras G, Tozman E, Nahar N, Metz D. Maintenance therapies for proliferative lupus nephritis: mycophenolate mofetil, azathioprine and intravenous cyclophosphamide. Lupus 2005;14(Suppl 1):S33‐8. [MEDLINE: ] - PubMed
CYCLOFA‐LUNE 2010 {published and unpublished data}
    1. Dostal C, Tesar V, Rysava R, Rovensky J, Rychlik I, Hrneio Z, et al. Cyclofa‐Lune (2002) lupus nephritis ‐ randomized controlled multicentric therapeutic comparative study with cyclosporin A versus cyclophosphamide: running evaluation [abstract no: THU0390]. Annual European Congress of Rheumatology EULAR 2004; 2004 Jun 9‐12, Berlin (Germany). 2004.
    1. Zavada AJ, Pesickova S, Rysava R, Horak P, Hrncir Z, Rovensky J, et al. Extended follow‐up of a investigator‐initiated trial comparing two sequential induction and maintenance treatment regimens for proliferative lupus nephritis based either on cyclophosphamide or cyclosporine [abstract no: 596]. Arthritis and Rheumatism 2013;65(10 Suppl):S256‐S7. [EMBASE: 71318082]
    1. Zavada J, Pesickova S, Rysava R, Olejarova M, Horak P, Hmcir Z, et al. Cyclosporine A or intravenous cyclophosphamide for lupus nephritis: the Cyclofa‐Lune study. Lupus 2010;19(11):1281‐9. [MEDLINE: ] - PubMed
    1. Zavada J, Pesickova SS, Rysava R, Horak P, Hrncir Z, Lukac J, et al. Extended follow‐up of the CYCLOFA‐LUNE trial comparing two sequential induction and maintenance treatment regimens for proliferative lupus nephritis based either on cyclophosphamide or on cyclosporine A. Lupus 2014;23(1):69‐74. [MEDLINE: ] - PubMed
Decker 1975 {published data only}
    1. Austin HA 3rd, Klippel JH, Balow JE, Riche NG, Steinberg AD, Plotz PH, et al. Therapy of lupus nephritis. Controlled trial of prednisone and cytotoxic drugs. New England Journal of Medicine 1986;314(10):614‐9. [MEDLINE: ] - PubMed
    1. Austin HA, Klippel J, Riche N, Decker JL, Balow JE. Immunosuppressive therapy of lupus nephritis [abstract]. Kidney International 1985;27(1):204. [CENTRAL: CN‐00550415]
    1. Austin, HA 3rd, Muenz LR, Joyce KM, Antonovych TA, Kullick ME, Klippel JH, et al. Prognostic factors in lupus nephritis. Contribution of renal histologic data. American Journal of Medicine 1983;75(3):382‐91. [MEDLINE: ] - PubMed
    1. Carette S, Klippel JH, Decker JL, Austin HA, Plotz PH, Steinberg AD, et al. Controlled studies of oral immunosuppressive drugs in lupus nephritis. A long‐term follow‐up. Annals of Internal Medicine 1983;99(1):1‐8. [MEDLINE: ] - PubMed
    1. Decker JL, Klippel JH, Plotz PH, Steinberg AD. Cyclophosphamide or azathioprine in lupus glomerulonephritis. A controlled trial: results at 28 months. Annals of Internal Medicine 1975;83(5):606‐15. [MEDLINE: ] - PubMed
Deng 2016 {published data only}
    1. Deng F, Hong D, Wang L. A clinical research of the effect of leflunomide as an induction treatment for proliferative lupus nephritis [abstract no: FR‐PO593]. Journal of the American Society of Nephrology 2016;27(Abstract Suppl):499A.
Derksen 1988 {published data only}
    1. Derksen RH, Hene RJ, Kallenberg CG, Valentijn RM, Kater L. Prospective multicentre trial on the short‐ term effects of plasma exchange versus cytotoxic drugs in corticosteroid‐resistant lupus nephritis. Netherlands Journal of Medicine 1988;33(3‐4):168‐77. [MEDLINE: ] - PubMed
Donadio 1972 {published data only}
    1. Donadio JVJ, Holley KE, Wagoner RD, Ferguson RH, McDuffie FC. Further observations on the treatment of lupus nephritis with prednisone and combined prednisone and azathioprine. Arthritis & Rheumatism 1974;17(5):573‐81. [MEDLINE: ] - PubMed
    1. Donadio JVJ, Holley KE, Wagoner RD, Ferguson RH, McDuffie FC. Treatment of lupus nephritis with prednisone and combined prednisone and azathioprine. Annals of Internal Medicine 1972;77(6):829‐35. [MEDLINE: ] - PubMed
Donadio 1976 {published data only}
    1. Donadio JV, Holley KE, Ferguson RH, Ilstrup D. Long‐term treatment of diffuse proliferative lupus nephritis (DPLN) with prednisone and combined prednisone and cyclophosphamide [abstract]. Kidney International 1977;12(6):465.
    1. Donadio JV, Holley KE, Ferguson RH, Ilstrup DM. Progressive lupus glomerulonephritis. Treatment with prednisone and combined prednisone and cyclophosphamide. Mayo Clinic Proceedings 1976;51(8):484‐94. [MEDLINE: ] - PubMed
    1. Donadio JV, Holley KE, Ferguson RH, Ilstrup DM. Treatment of diffuse proliferative lupus nephritis with prednisone and combined prednisone and cyclophosphamide. New England Journal of Medicine 1978;299(21):1151‐5. [MEDLINE: ] - PubMed
Doria 1994 {published data only}
    1. Doria A, Piccoli A, Vesco P, Vaccaro E, Marson P, Silvestro G, et al. Therapy of lupus nephritis. A two‐year prospective study. Annales de Medecine Interne 1994;145(5):307‐11. [MEDLINE: ] - PubMed
Dyadyk 2001 {published and unpublished data}
    1. Dyadyk A, Vasilenko I, Bagriy A, Dyadyk O, Yarovaya N, Roschin Y, et al. Azathioprine and cyclophosphamide in treatment of patients with diffuse proliferative lupus nephritis ‐ a randomized controlled study [abstract]. Nephrology Dialysis Transplantation 2001;16(6):A57.
    1. Dyadyk OI, Vasilenko IV, Bagriy AE, Kholopov LS, Dyadyk OO, Yarovaya NF, et al. Azathioprine and cyclophosphamide in diffuse proliferative lupus nephritis treatment ‐ a randomized controlled study [abstract no: SAT0125]. Annals of the Rheumatic Diseases 2007;66(Suppl II):467.
El‐Sehemy 2006 {published data only}
    1. Abd‐ELHady El‐Sehemy M, Al‐Saaran AM, Al‐Saeed Baddour NM, El‐Sayed Moez P, Adam AG. Comparative clinical prospective therapeutic study between cyclophosphamide, cyclosporine and azathioprine in the treatment of lupus nephritis [abstract]. 41st Congress. European Renal Association. European Dialysis and Transplantation Association; 2004 May 15‐18; Lisbon (Portugal). 2004:48.
    1. Abd‐ELHady El‐Sehemy M, Al‐Saaran AM, Al‐Saeed Baddour NM, El‐Sayed Moez P, Gaber Adam A. Cyclosporine but not cyclophosphamide is a rescue therapy in resistant lupus nephritis even in class iv proliferative GN [abstract]. 41st Congress. European Renal Association. European Dialysis and Transplantation Association; 2004 May 15‐18; Lisbon (Portugal). 2004:48.
    1. Adam AG, El‐Sehemy MS, Baddour NM, Moez PE, Al Saaran AM. Prospective comparative study between azathioprine "AZA", cyclophosphamide "CYP", cyclosporine "CsA" and mycophenolate mofetil "MMF" in the treatment of lupus nephritis: is CYP still the preferred therapy against the new‐comer MMF. AZA: an old drug with still a great potential? [abstract no: F‐PO258]. Journal of the American Society of Nephrology 2004;15(Oct):122A.
    1. El‐Sehemy MS, Al‐Saaran AM, Baddour NM, Adam AG, Moez PE. Comparative clinical prospective therapeutic study between cyclophosphamide, cyclosporine and azathioprine in the treatment of lupus nephritis. Egyptian Journal of Immunology/Egyptian Association of Immunologists 2006;13(1):39‐52. [MEDLINE: ] - PubMed
El‐Shafey 2010 {published and unpublished data}
    1. Shafey EM, Abdou SH, Shareef MM. Is mofetil superior to pulse intravenous cyclophosphamide for induction therapy of proliferative lupus nephritis in Egyptian patients?. Clinical & Experimental Nephrology 2010;14(3):214‐21. [MEDLINE: ] - PubMed
Florez‐Suarez 2004 {published and unpublished data}
    1. Flores‐Suarez LF, Villa AR. Open randomized trial comparing mycophenolate mofetil (MMF) vs intravenous cyclophosphamide (IV‐CYC) as induction therapy for severe lupus nephritis (LN) [abstract no: F‐PO257]. Journal of the American Society of Nephrology 2004;15(Oct):122A.
    1. Flores‐Suarez LF, Villa AR. Preliminary results of an open randomised clinical trial comparing mycophenolate mofetil (MMF) vs intravenous cyclophosphamide (IV‐CYC) as induction therapy for severe lupus nephritis [abstract no: THU0413]. Annual European Congress of Rheumatology EULAR 2004; 2004 Jun 9‐12, Berlin, Germany. 2004.
Fries 1973 {published data only}
    1. Fries JF, Sharp GC, McDevitt HO, Holman HR. Cyclophosphamide therapy in systemic lupus erythematosus and polymyositis. Arthritis & Rheumatism 1973;16(2):154‐62. [MEDLINE: ] - PubMed
Fu 1997 {published data only}
    1. Fu LW, Yang LY, Chen WP, Lin CY. Clinical efficacy of cyclosporin A neoral in the treatment of paediatric lupus nephritis with heavy proteinuria. British Journal of Rheumatology 1998;37(2):217‐21. [MEDLINE: ] - PubMed
    1. Fu LW, Yang LY, Chen WP, Lin CY. Cyclosporin pharmacokinetics following administration of capsules and Neoral in paediatric patients with lupus nephritis. British Journal of Clinical Pharmacology 1997;44(2):125‐7. [MEDLINE: ] - PMC - PubMed
Furie 2014 {published data only}
    1. Furie R, Nicholls K, Cheng TT, Houssiau F, Burgos‐Vargas R, Chen SL. Efficacy and safety of abatacept over 12 months in patients with lupus nephritis: results from a multicenter, randomized, double‐blind, placebo‐controlled phase II/III study [abstract]. Arthritis & Rheumatism 2014;63(10 Suppl 1):S962‐3. [EMBASE: 70785447]
    1. Furie R, Nicholls K, Cheng TT, Houssiau F, Burgos‐Vargas R, Chen SL, et al. Efficacy and safety of abatacept in lupus nephritis: a twelve‐month, randomized, double‐blind study. Arthritis & Rheumatology 2014;66(2):379‐89. [MEDLINE: ] - PubMed
    1. Wofsy D, Hillson JL, Diamond B. Abatacept for lupus nephritis: alternative definitions of complete response support conflicting conclusions. Arthritis & Rheumatism 2012;64(11):3660‐5. [MEDLINE: ] - PubMed
    1. Wofsy D, Hillson JL, Diamond B. Comparison of alternative primary outcome measures for use in lupus nephritis clinical trials. Arthritis & Rheumatism 2013;65(6):1586‐91. [MEDLINE: ] - PMC - PubMed
Ginzler 1976 {published data only}
    1. Ginzler E, Diamond H, Guttadauria M, Kaplan D. Prednisone and azathioprine compared to prednisone plus low‐dose azathioprine and cyclophosphamide in the treatment of diffuse lupus nephritis. Arthritis & Rheumatism 1976;19(4):693‐9. [MEDLINE: ] - PubMed
Ginzler 2005 {published and unpublished data}
    1. Appel G, Ginzler E, Radhakrishnan J, Aranow C, Buyon J, Dooley M, et al. Multicenter controlled trial of mycophenolate mofetil (MMF) vs intravenous cyclophosphamide (IVC) as induction therapy for severe lupus nephritis (LN) [abstract no: SA‐FC171]. Journal of the American Society of Nephrology 2003;14(Nov):38A.
    1. Burchardi C, Schlondorff D. Induction therapy for active lupus nephritis: mycophenolate mofetil versus cyclophosphamide. Nature Clinical Practice Nephrology 2006;2(6):314‐5. [MEDLINE: ] - PubMed
    1. Elliott JR, Manzi S. Induction therapy for active lupus nephritis: mycophenolate mofetil is superior to cyclophosphamide. Nature Clinical Practice Rheumatology 2006;2(7):354‐5. [MEDLINE: ] - PubMed
    1. Ginzler EM, Dooley MA, Aranow C, Kim MY, Buyon J, Merrill JT, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. New England Journal of Medicine 2005;353(21):2219‐28. [MEDLINE: ] - PubMed
    1. Karassa FB. Mycophenolate mofetil or intravenous cyclophosphamide in lupus nephritis. New England Journal of Medicine 2006;354(7):764‐5. [MEDLINE: ] - PubMed
Gourley 1996 {published data only}
    1. Gourley MF, Austin HA, Scott D, Yarboro CH, Vaughan EM, Muir J, et al. Methylprednisolone and cyclophosphamide, alone or in combination, in patients with lupus nephritis. A randomized, controlled trial. Annals of Internal Medicine 1996;125(7):549‐57. [MEDLINE: ] - PubMed
    1. Illei GG, Austin HA, Crane M, Collins L, Gourley MF, Yarboro CH, et al. Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long‐term renal outcome without adding toxicity in patients with lupus nephritis. Annals of Internal Medicine 2001;135(4):248‐57. [MEDLINE: ] - PubMed
    1. Illei GG, Takada K, Parkin D, Austin HA, Crane M, Yarboro CH, et al. Renal flares are common in patients with severe proliferative lupus nephritis treated with pulse immunosuppressive therapy: long‐term followup of a cohort of 145 patients participating in randomized controlled studies. Arthritis & Rheumatism 2002;46(4):995‐1002. [MEDLINE: ] - PubMed
Grootscholten 2006 {published and unpublished data}
    1. Arends S, Grootscholten C, Bijl M, Berger SP, Sevaux R, Voskuyl AE, et al. Cyclophosphamide versus azathioprine/methylprednisolone: long‐term follow‐up of the first Dutch lupus nephritis study [abstract]. Lupus 2011;20(4):350. [EMBASE: 70414154]
    1. Arends S, Grootscholten C, Derksen RH, Berger SP, Sevaux RG, Voskuyl AE, et al. Long‐term follow‐up of a randomised controlled trial of azathioprine/methylprednisolone versus cyclophosphamide in patients with proliferative lupus nephritis. Annals of the Rheumatic Diseases 2012;71(6):966‐73. [MEDLINE: ] - PubMed
    1. Grootscholten C, Bajema IM, Florquin S, Steenbergen EJ, Peutz‐Kootstra CJ, Goldschmeding R, et al. Interobserver agreement of scoring of histopathological characteristics and classification of lupus nephritis. Nephrology Dialysis Transplantation 2008;23(1):223‐30. [MEDLINE: ] - PubMed
    1. Grootscholten C, Bajema IM, Florquin S, Steenbergen EJ, Peutz‐Kootstra CJ, Goldschmeding R, et al. Treatment with cyclophosphamide delays the progression of chronic lesions more effectively than does treatment with azathioprine plus methylprednisolone in patients with proliferative lupus nephritis. Arthritis & Rheumatism 2007;56(3):924‐37. [MEDLINE: ] - PubMed
    1. Grootscholten C, Bijl M, Ligtenberg G, Hagen EC, Wall Bake AW, Glas‐Vos JW, et al. Is azathioprine an alternative for cyclophosphamide in the treatment of patients with proliferative lupus nephritis? Two year results of the Dutch Lupus Nephritis Study [abstract no: OP0176]. Annual European Congress of Rheumatology EULAR; 2004 Jun 9‐12; Berlin (Germany). 2004.
Hahn 1975 {published data only}
    1. Hahn BH, Kantor OS, Osterland CK. Azathioprine plus prednisone compared with prednisone alone in the treatment of systemic lupus erythematosus. Report of a prospective controlled trial in 24 patients. Annals of Internal Medicine 1975;83(5):597‐605. [MEDLINE: ] - PubMed
Hong 2007 {published and unpublished data}
    1. Hong R, Haijin Y, Xianglin W, Cuilan H, Nan C. A preliminary study of tacrolimus versus cyclophosphamide in patients with diffuse proliferative lupus nephritis [abstract no: SaP131]. Nephrology Dialysis Transplantation 2007;22(Suppl 6):vi276.
Houssiau 2002 {published data only}
    1. Dall'Era M, Cisternas MG, Smilek DE, Straub L, Houssiau FA, Cervera R, et al. Predictors of long‐term renal outcome in lupus nephritis trials: lessons learned from the Euro‐Lupus Nephritis cohort. Arthritis & Rheumatology 2015;67(5):1305‐13. [MEDLINE: ] - PubMed
    1. Houssiau FA. The 10‐year followup of the Euro‐Lupus Nephritis Trial (ELNT), a randomized prospective trial comparing low‐dose (LD) versus high‐dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment of proliferative lupus nephritis [abstract no: 2060]. ACR/ARHP Annual Scientific Meeting; 2008 Oct 24‐29; San Francisco (CA). 2008.
    1. Houssiau FA, Cosyns J, Cervera R. The Euro‐Lupus Nephritis Trial: 5‐year follow‐up [abstract no: OP0054]. Annual European Congress of Rheumatology EULAR; 2003 June 18‐21; Lisbon (Portugal). 2003.
    1. Houssiau FA, Vasconcelos C, D'Cruz D, Sebastiani G, Ramon Garrido E, Danieli M, et al. Long term outcome of patients randomized in the Euro‐Lupus Nephritis Trial: further evidence that a low‐dose IV cyclophosphamide induction regimen achieves good results [abstract no: OP0034]. Annals of the Rheumatic Diseases 2006;65(Suppl II):64.
    1. Houssiau FA, Vasconcelos C, D'Cruz D, Sebastiani GD, Garrido Ed Ede R, Danieli MG, et al. Immunosuppressive therapy in lupus nephritis: the Euro‐Lupus Nephritis Trial, a randomized trial of low‐dose versus high‐dose intravenous cyclophosphamide. Arthritis & Rheumatism 2002;46(8):2121‐31. [MEDLINE: ] - PubMed
Jayne 2013 {published data only}
    1. Jayne D, Appel G, Chan TM, Barkay H, Weiss R, Wofsy D. A randomized controlled study of laquinimod in active lupus nephritis patients in combination with standard of care [abstract no: LB0003]. Annals of the Rheumatic Diseases 2013;72(Suppl 3):164.
Kaballo 2016 {published data only}
    1. Kaballo BG, Ahmed AE, Nur MM, Khalid IO, Abu‐Aisha H. Mycophenolate mofetil versus azathioprine for maintenance treatment of lupus nephritis. Saudi Journal of Kidney Diseases & Transplantation 2016;27(4):717‐25. [MEDLINE: ] - PubMed
Kamanamool 2017 {published data only}
    1. Kamanamool N, Ingsathit A, Rattanasiri S, Ngamjanyaporn P, Kasitanont N, Chawanasuntorapoj R, et al. Comparison of disease activity between tacrolimus and mycophenolate mofetil in lupus nephritis: a randomized controlled trial. Lupus 2017;27(4):647‐56. [MEDLINE: ] - PubMed
    1. Sumethkul V. Comparison between tacrolimus (TAC) and mycophenolate mofetil (MMF) for induction of remission in lupus nephritis. clinicaltrials.gov/ct2/show/NCT01580865 (first received 17 April 2012).
Lewis 1992 {published data only}
    1. Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ. The value of a partial remission in severe lupus nephritis [abstract no: SA‐PO743]. Journal of the American Society of Nephrology 2006;17(Abstracts):731A. - PMC - PubMed
    1. Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ, Collaborative Study Group. Value of a complete or partial remission in severe lupus nephritis. Clinical Journal of the American Society of Nephrology: CJASN 2008;3(1):46‐53. [MEDLINE: ] - PMC - PubMed
    1. Clough JD, Lewis EJ, Lachin JM. Treatment protocols of the lupus nephritis collaborative study of plasmapheresis in severe lupus nephritis. The Lupus Nephritis Collaborative Study Group. Progress in Clinical & Biological Research 1990;337:301‐7. [MEDLINE: ] - PubMed
    1. Korbet SM, Schwartz MM, Evans J, Lewis EJ, Collaborative Study Group. Severe lupus nephritis: racial differences in presentation and outcome. Journal of the American Society of Nephrology 2007;18(1):244‐54. [MEDLINE: ] - PubMed
    1. Korbet SM, Whittier WL, Lewis EJ. Complete remission rate and outcome in severe lupus nephritis: the impact of baseline serum creatinine [abstract no: TH‐PO769]. Journal of the American Society of Nephrology 2015;26(Abstract Suppl):266A.
Li 2009c {published and unpublished data}
    1. Li EK, Tam LS, Zhu TY, Kwok CL, Leung YY, Szeto CC. Rituximab monotherapy is an effective induction therapy in proliferative lupus nephritis: a pilot study [abstract no: THU0223]. Annals of the Rheumatic Diseases 2009;68(Suppl 3):247.
    1. Li EK, Tam LS, Zhu TY, Li M, Kwok CL, Li TK, et al. Is combination rituximab with cyclophosphamide better than rituximab alone in the treatment of lupus nephritis?. Rheumatology 2009;48(8):892‐8. [MEDLINE: ] - PubMed
Li 2012 {published and unpublished data}
    1. Li X, Ren H, Zhang Q, Zhang W, Wu X, Xu Y, et al. Mycophenolate mofetil or tacrolimus compared with intravenous cyclophosphamide in the induction treatment for active lupus nephritis. Nephrology Dialysis Transplantation 2012;27(4):1467‐72. [MEDLINE: ] - PubMed
    1. Li X, Ren H, Zhang W, Xu Y, Shen P, Zhang Q, et al. Induction therapies for proliferative lupus nephritis: mycophenolate mofetil, tacrolimus and intravenous cyclophosphamide [abstract]. Journal of the American Society of Nephrology 2009;20:391A.
Liou 2007 {published data only}
    1. Liou C, Ni Z, Qian J, Lin A, Zhang W, Fang W, et al. Treatment of lupus nephritis type_and_with leflunomide: A two year prospective sequential therapies [abstract no: M‐PO‐1081]. 4th World Congress of Nephrology.19th International Congress of the International Society of Nephrology (ISN); 2007 Apr 21‐25; Rio de Janeiro, Brazil. 2007:349.
Liu 2015 {published data only}
    1. Liu Z, Zhang H, Liu Z, Xing C, Fu P, Ni Z, et al. Multitarget therapy for induction treatment of lupus nephritis: a randomized trial.[Summary for patients in Ann Intern Med. 2015 Jan 6;162(1):I24; PMID: 25383607]. Annals of Internal Medicine 2015;162(1):18‐26. [MEDLINE: ] - PubMed
Loo 2010 {published data only}
    1. Loo CY, Kong NCT, Shahrir M, Suriani A, Halim AG, Rozita M, et al. Plasmapheresis versus immunoadsorption in severe lupus nephritis (LN) [abstract no: M‐PO‐0967]. 4th World Congress of Nephrology.19th International Congress of the International Society of Nephrology (ISN); 2007 Apr 21‐25; Rio de Janeiro, Brazil. 2007:319.
    1. Loo CY, Mohamed Said MS, Mohd R, Abdul Gafor AH, Saidin R, Halim NA, et al. Immunoadsorption and plasmapheresis are equally efficacious as adjunctive therapies for severe lupus nephritis. Transfusion & Apheresis Science 2010;43(3):335‐40. [MEDLINE: ] - PubMed
Lui 1997 {published and unpublished data}
    1. Lui SF, Cheng IKP, Tong KL, Li CS, Wong KC, Chan TM, et al. Treatment of type iv lupus nephritis (LN) ‐ comparison of 2 triple therapy regimens: cyclosporin a (CSA), prednisolone (PRED), azathioprine (AZA) vs. oral cyclophosphamide (POCP), prednisolone, azathioprine [abstract no: P1613]. Nephrology 1997;3(Suppl 1):S476.
LUNAR 2012 {published and unpublished data}
    1. Appel GB, Looney RJ, Eisenberg RA, Rovin BH, Ginzler EM, Adler SG, et al. Protocol for the Lupus Nephritis Assessment with rituximab (LUNAR) Study [abstract no: F‐PO1121]. Journal of the American Society of Nephrology 2006;17(Abstracts):573A.
    1. Furie R, Looney J, Rovin B, Latinis K, Appel G, Sanchez‐Guerrero J, et al. Efficacy and safety of rituximab (RTX) in patients (Pts) with proliferative lupus nephritis (LN): results from randomized, double‐blind phase III LUNAR study at week 52 [abstract no: CS6.6]. Lupus 2010;19(1 Suppl):15.
    1. Furie R, Looney J, Rovin B, Latinis K, Appel G, Sanchez‐Guerrero J, et al. Efficacy and safety of rituximab in patients with proliferative lupus nephritis: results from the randomized, double‐blind phase III LUNAR study [abstract no: SAT0185]. Annals of the Rheumatic Diseases 2010;69(Suppl 3):549.
    1. Furie R, Looney RJ, Rovin B, Latinis KM, Appel G, Sanchez‐Guerrero J, et al. Efficacy and safety of rituximab in subjects with active proliferative lupus nephritis (LN): results from the randomized, double‐blind phase III LUNAR study [abstract no: 1149]. ACR/ARHP Annual Scientific Meeting; 2009 Oct 17‐21; Philadelphia (PA). 2009.
    1. Furie R, Rovin B, Appel G, Kamen D, Fervenza F, Spindler A, et al. Effect of rituximab (RTX) on anti‐dsDNA and C3 levels and relationship to response: results from the LUNAR trial [abstract no: PO2.E.22]. Lupus 2010;19(1 Suppl):157.
MAINTAIN Nephritis 2010 {published and unpublished data}
    1. Houssiau FA, D'Cruz D, Sangle S, Remy P, Vasconcelos C, Petrovic R, et al. Azathioprine versus mycophenolate mofetil for long‐term immunosuppression in lupus nephritis: results from the MAINTAIN Nephritis Trial. Annals of the Rheumatic Diseases 2010;69(12):2083‐9. [MEDLINE: ] - PMC - PubMed
    1. Houssiau FA, D'Cruz D, Sangle S, Remy P, Vasconcelos C, Petrovic R, et al. Longterm renal outcome in lupus nephritis patients can be predicted by the kinetics of proteinuria drop in response to therapy: data from the MAINTAIN NEPHRITIS trial [abstract no: SAT0193]. Annals of the Rheumatic Diseases 2010;69(Suppl 3):552.
    1. Houssiau FA, D'Cruz DP, Sangle SR, Remy P, Vasconcelos C, Ramon Garrido E, et al. Azathioprine versus mycophenolate mofetil for maintenance immunosuppression of proliferative lupus nephritis: results of a randomized trial (MAINTAIN) [abstract no: 1150]. ACR/ARHP Annual Scientific Meeting; 2009 Oct 17‐21; Philadelphia (PA). 2009.
    1. Stoenoiu MS, Aydin S, Tektonidou M, Ravelingien I, Guern V, Fiehn C, et al. Repeat kidney biopsies fail to detect differences between azathioprine and mycophenolate mofetil maintenance therapy for lupus nephritis: data from the MAINTAIN Nephritis Trial. Nephrology Dialysis Transplantation 2012;27(5):1924‐30. [MEDLINE: ] - PubMed
    1. Tamirou F, D'Cruz D, Sangle S, Remy P, Vasconcelos C, Fiehn C, et al. Long‐term follow‐up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis. Annals of the Rheumatic Diseases 2016;75(3):526‐31. [MEDLINE: ] - PMC - PubMed
Mehra 2018 {published data only}
    1. Mehra S, Usdadiya JB, Jain VK, Misra DP, Negi VS. Comparing the efficacy of low‐dose vs high‐dose cyclophosphamide regimen as induction therapy in the treatment of proliferative lupus nephritis: a single center study. Rheumatology International 2018;38(4):577‐68. [MEDLINE: ] - PubMed
Mendonca 2017 {published data only}
    1. Mendonca S, Gupta D, Ali S, Gupta P. Mycophenolate mofetil or cyclophosphamide in Indian patients with lupus nephritis: Which is better? A single‐center experience. Saudi Journal of Kidney Diseases & Transplantation 2017;28(5):1069‐77. [MEDLINE: ] - PubMed
Mitwalli 2011 {published data only}
    1. Mitwalli AH, Al Wakeel JS, Hurraib S, Aisha A, Al Suwaida A, Alam A, et al. Comparison of high and low dose of cyclophosphamide in lupus nephritis patients: a long‐term randomized controlled trial. Saudi Journal of Kidney Diseases & Transplantation 2011;22(5):935‐40. [MEDLINE: ] - PubMed
Mok 2016 {published and unpublished data}
    1. Mok C, Ying K, Tong K, Siu Y, To C, Yim C, et al. Mycophenolate mofetil versus tacrolimus for active lupus nephritis: an extended observation of a randomized controlled trial [abstract no: 1073]. ACR/ARHP Annual Scientific Meeting; 2008 Oct 24‐29; San Francisco (CA). 2008.
    1. Mok CC. Factors determining response in patients with acute lupus nephritis treated with glucocorticoids and mycophenolate mofetil (MMF) [abstract]. Arthritis and Rheumatism 2009;60(Suppl 10):923.
    1. Mok CC, Ho LY, To CH, Chan KL. Factors associated with renal remission, relapse and long‐term renal function decline in lupusnephritis treated with combined prednisolone and mycophenolate mofetil (MMF) or tacrolimus(TAC) [abstract no: 988]. Arthritis & Rheumatology 2015;67(10 Suppl):988. [EMBASE: 72094876]
    1. Mok CC, To CH, Ying KY, Yim C, Ng WL. Factors associated with long‐term renal function deterioration in lupus nephritis treated initially with combined prednisolone and mycophenolate mofetil (MMF) or tacrolimus (TAC) [abstract no: 600]. Arthritis & Rheumatism 2013;65(Suppl 10):S258‐9. [EMBASE: 71318086]
    1. Mok CC, Ying KY, Ng CW, Ng WL. Risk of renal flares and decline in renal function in patients with active lupus nephritis treated with mycophenolate mofetil (MMF) [abstract no: SAT0202]. Annals of the Rheumatic Diseases 2010;69(3):555.
Moroni 2006 {published and unpublished data}
    1. Doria A, Ponticelli C, Mosca M, Ferraccioli GF, Moroni G, Todesco S, et al. A randomized trial comparing cyclosporine versus azathioprine for maintenance therapy in diffuse lupus nephritis [abstract]. Lupus 2004; 7th International Congress on SLE and Related Conditions; 2004 May 9‐13; New York (NY). 2004.
    1. Moroni G, Doria A, Mosca M, Alberighi O, Ferraccioli G, Todesco S, et al. A randomized pilot trial comparing cyclosporine and azathioprine for maintenance therapy in diffuse lupus nephritis over four years. Clinical Journal of the American Society of Nephrology: CJASN 2006;1(5):925‐32. [MEDLINE: ] - PubMed
    1. Moroni G, Doria A, Mosca M, Ferraccioli G, Todesco S, Manno C, et al. A randomized trial comparing cyclosporine versus azathioprine for maintenance therapy in diffuse lupus nephritis [abstract no: F‐PO255]. Journal of the American Society of Nephrology 2004;15(Oct):121A. - PubMed
    1. Moroni G, Doria A, Mosca M, Ferraccioli G, Todesco S, Schena P, et al. A randomized trial comparing cyclosporine versus azathioprine for maintenance therapy in diffuse lupus nephritis [abstract no: MO30]. 41st Congress. European Renal Association. European Dialysis and Transplantation Association; 2004 May 15‐18; Lisbon, Portugal. 2004:224.
    1. Mosca M, Doria A, Moroni G, Ferrara R, Todesco S, Ponticelli C, et al. Induction therapy with oral cyclophosphamide in lupus nephritis [abstract no: THU0166]. Annual European Congress of Rheumatology EULAR; 2002 June 12‐15; Stockholm, Sweden. 2002.
Mulic‐Bacic 2008 {published and unpublished data}
    1. Mulic‐Bacic S, Antic D, Krizic M, Hajdarovic A, Mulic E. Mycophenolate mofetil or intravenous cyclophosphamide in treatment of lupus nephritis [abstract no: FRI0201]. Annals of the Rheumatic Diseases 2008;67(Suppl II):349.
MyLupus 2011 {published and unpublished data}
    1. Jayne D, Amoura Z, Zeher M, Boletis J, Hiepe F. Enteric‐coated mycophenolate sodium in patients with lupus nephritis: rationale and design of a multicenter randomized steroid‐sparing trial [abstract no: M‐PO‐1114]. 4th World Congress of Nephrology. 19th International Congress of the International Society of Nephrology (ISN); 2007 Apr 21‐25; Rio de Janeiro, Brazil. 2007:357.
    1. Jayne DR, Zeher M. Enteric‐coated mycophenolate sodium (ED‐MPS) for the treatment of lupus nephritis ‐ MyLupus study [abstract no: SA‐PO2253]. Journal of the American Society of Nephrology 2010;21:626A.
    1. Zeher M, Doria A, Lan J, Aroca G, Jayne D, Boletis I, et al. Efficacy and safety of enteric‐coated mycophenolate sodium in combination with two glucocorticoid regimens for the treatment of active lupus nephritis. Lupus 2011;20(14):1484‐93. [MEDLINE: ] - PubMed
    1. Zeher M, Doria A, Lan JL, Aroca G, Amoura Z, Jayne D, et al. Efficacy and safety of enteric‐coated mycophenolate sodium (EC‐MPS) in combination with two corticosteroid regimens for the treatment of lupus nephritis flare – results of the MYLUPUS study [abstract no: SAT0213]. Annals of the Rheumatic Diseases 2010;69(3):559.
    1. Zeher M, Lan J, Doria A, Amoura Z, Jayne D, Hiepe F. Enteric coated mycophenolate sodium (EC‐MPS) treatment of lupus nephritis flare ‐ interim results from a multicenter, randomized trial [abstract no: THU0234]. Annals of the Rheumatic Diseases 2009;68(Suppl 3):250.
Nakamura 2002e {published data only}
    1. Nakamura T, Ushiyama C, Hara M, Osada S, Ugai K, Shimada N, et al. Comparative effects of plasmapheresis and intravenous cyclophosphamide on urinary podocyte excretion in patients with proliferative lupus nephritis. Clinical Nephrology 2002;57(2):108‐13. [MEDLINE: ] - PubMed
Ong 2005 {published data only}
    1. Ong LM, Hooi LS, Lim TO, Goh BL, Ahmad G, Ghazalli R, et al. Randomized controlled trial of pulse intravenous cyclophosphamide versus mycophenolate mofetil in the induction therapy of proliferative lupus nephritis. Nephrology 2005;10(5):504‐10. [MEDLINE: ] - PubMed
    1. Ong LM, Hooi LS, Lim TO, Goh BL, Ahmad G, Ghazalli R, et al. Randomized controlled trial of pulse intravenous cyclophosphamide versus mycophenolate mofetil in the induction therapy of proliferative lupus nephritis [abstract no: FC30041]. Nephrology 2005;10(Suppl):A121. - PubMed
Pal 2017 {published data only}
    1. Pal A, Roychowdhury A, Ghosh P. Comparison of tacrolimus‐azathioprine combination versus cyclophosphamide for induction treatment of proliferative lupus nephritis [abstract no: OC014]. Indian Journal of Rheumatology 2017;12(5 Suppl 1):S9. [EMBASE: 619738235]
Rathi 2016 {published data only}
    1. Goyal A, Rathi M, Jha V, Sharma A, Joshi K, Nada R, et al. Randomized controlled trial of low dose intravenous cyclophosphamide versus oral mycophenolate mofetil in treatment of lupus nephritis [abstract no: FR‐OR053]. Journal of the American Society of Nephrology 2013;24(Abstracts):48A‐9A.
    1. Rathi M, Goyal A, Gupta PK, Jaryal A, Sharma A, Jha V, et al. Randomized controlled trial of low‐dose intravenous cyclophosphamide versus oral mycophenolate mofetil in treatment of lupus nephritis [abstract]. Nephrology Dialysis Transplantation 2014;29(Suppl 3):iii28‐iii2. [EMBASE: 71491534]
    1. Rathi M, Goyal A, Jaryal A, Sharma A, Gupta PK, Ramachandran R, et al. Comparison of low‐dose intravenous cyclophosphamide with oral mycophenolate mofetil in the treatment of lupus nephritis. Kidney International 2016;89(1):235‐42. [MEDLINE: ] - PubMed
    1. Rathi M, Jaryal A, Goyal A, Sharma A, Gupta P, Gupta K. Outcomes in lupus nephritis patients previously randomized to receive either low dose cyclophosphamide versus oral mycophenolate mofetil on azathioprine maintenance [abstract no: 2941]. Arthritis & Rheumatology 2015;67(Suppl 10):2941. [EMBASE: 72096818]
Rovin 2016 {published data only}
    1. Aranow C, Vollenhoven R, Rovin B, Wagner C, Zhou B, Gordon R, et al. A phase 2, multicenter, randomized, double‐blind, placebo‐controlled, proof‐of‐concept study to evaluate the efficacy and safety of sirukumab in patients with active lupus nephritis [abstract no: 2835]. Arthritis & Rheumatology 2014;66(Suppl 10):S1239. [EMBASE: 71738820]
    1. Rovin B, Vollenhoven R, Aranow C, Wagner C, Gordon R, Zhuang Y, et al. A multicenter, randomized, double‐blind, placebo‐controlled study to evaluate the efficacy and safety of treatment with sirukumab (CNTO 136) in patients with active lupus nephritis. Arthritis & Rheumatology 2016;68(9):2174‐83. [MEDLINE: ] - PMC - PubMed
    1. Rovin, BH, Vollenhoven R, Aranow C, Wagner C, Gordon R, Hsu B, et al. Efficacy and safety of sirukumab in patients with active lupus nephritis: results from a phase 2, multicenter, randomized, double‐blind, placebo‐controlled, proof‐of‐concept study [abstract no: TH‐PO426]. Journal of the American Society of Nephrology 2014;25:204A.
Sabry 2009 {published and unpublished data}
    1. Sabry A, Abo‐Zenah H, Medhat T, Sheashaa H, Mahmoud K, El‐Huseini A. A comparative study of two intensified pulse cyclophosphamide remission‐inducing regimens for diffuse proliferative lupus nephritis: an Egyptian experience. International Urology & Nephrology 2009;41(1):153‐61. [MEDLINE: ] - PubMed
    1. Sabry A, Sheashaa H, Mahmoud K, El‐Huseini A, Dahshan K. A comparative study of two intensified pulse cyclophosphamide remission‐inducing regimen for diffuse proliferative lupus nephritis: an Egyptian experience [abstract no: FP036]. Nephrology Dialysis Transplantation 2007;22(Suppl 6):vi28. - PubMed
Sedhain 2016 {published data only}
    1. Sedhain A, Hada R, Agrawal RK, Baral A, Bhattarai GR. Effect of cyclophosphamide versus mycophenolate mofetil in induction therapy of lupus nephritis in Nepalese population [abstract no: FR‐PO598]. Journal of the American Society of Nephrology 2016;27(Abstract Suppl):500A.
Sesso 1994a {published data only}
    1. Sesso R, Monteiro M, Sato E, Kirsztajn G, Silva L, Ajzen H. A controlled trial of pulse cyclophosphamide versus pulse methylprednisolone in severe lupus nephritis. Lupus 1994;3(2):107‐12. [MEDLINE: ] - PubMed
    1. Sesso R, Monteiro M, Silva L, Sato E, Ajzen H. Pulse cyclophosphamide (CY) versus pulse methylprednisolone (MP) in severe lupus nephritis [abstract no: 97P]. Journal of the American Society of Nephrology 1993;4(Program & Abstracts):286.
SIMPL 2014 {published data only}
    1. Galbraith L, Manns B, Hemmelgarn B, Walsh M. The Steroids In the Maintenance of remission of Proliferative Lupus nephritis (SIMPL) pilot trial. Canadian Journal of Kidney Health & Disease 2014;1:30. [MEDLINE: ] - PMC - PubMed
Steinberg 1971 {published data only}
    1. Steinberg AD, Kaltreider HB, Staples PJ, Goetzl EJ, Talal N, Decker JL. Cyclophosphamide in lupus nephritis: a controlled trial. Annals of Internal Medicine 1971;75(2):165‐71. [MEDLINE: ] - PubMed
Sun 2015 {published data only}
    1. Sun J, Zhang H, Ji Y, Gui M, Yi B, Wang J, et al. Efficacy and safety of cyclophosphamide combined with mycophenolate mofetil for induction treatment of class IV lupus nephritis. International Journal of Clinical & Experimental Medicine 2015;8(11):21572‐8. [MEDLINE: ] - PMC - PubMed
Wallace 1998 {published data only}
    1. Wallace DJ, Goldfinger D, Pepkowitz SH, Fichman M, Metzger Al, Schroeder JO, et al. Randomized controlled trial of pulse/synchronization cyclophosphamide/apheresis for proliferative lupus nephritis. Journal of Clinical Apheresis 1998;13(4):163‐6. [MEDLINE: ] - PubMed
Yap 2017 {published data only}
    1. Yap DY, Lee P, Yam I, Tam CH, Wong S, Yung S, et al. Effect of cyclophosphamide and mycophenolate mofetil on lymphocyte subsets in patients with active lupus nephritis effect of cyclophosphamide and mycophenolate mofetil on lymphocyte subsets in patients with active lupus nephritis [abstract no: MP230]. Nephrology Dialysis Transplantation 2017;32(Suppl 3):iii510. [EMBASE: 617289724]
Yee 2004 {published data only}
    1. Yee CS, Gordon C, Dostal C, Petera P, Dadoniene J, Griffiths B, et al. EULAR randomised controlled trial of pulse cyclophosphamide and methylprednisolone versus continuous cyclophosphamide and prednisolone followed by azathioprine and prednisolone in lupus nephritis. Annals of the Rheumatic Diseases 2004;63(5):525‐9. [MEDLINE: ] - PMC - PubMed
Zhang 1995a {published data only}
    1. Zhang J, Yang H. Cyclophosphamide (CTX) pulse therapy in lupus nephritis (LN): short term is better [abstract no: T235]. Nephrology Dialysis Transplantation 2003;18(Suppl 4):356.
    1. Zhang JH, Yang H. Cyclophosphamide (CYX) pulse therapy in lupus nephritis (ln): short term is better [abstract]. ISN XIII International Congress of Nephrology; 1995 Jul 2‐6; Madrid (Spain). 1995:290.

References to studies excluded from this review

Andrade‐Ortega 2010 {published data only}
    1. Andrade‐Ortega L, Irazoque‐Palazuelos F, Lopez‐Villanueva R, Barragan‐Navarro Y, Bourget‐Pietrasanta F, Diaz‐Ceballos ML, et al. Efficacy of rituximab versus cyclophosphamide in lupus patients with severe manifestations. A randomized and multicenter study [Eficacia de rituximab comparado con ciclofosfamida en pacientes con manifestaciones graves de lupus eritematoso generalizado. Estudio aleatorizado y multicentrico]. Reumatologia Clinica 2010;6(5):250‐5. [EMBASE: 2010499791] - PubMed
Antunes 2001 {published data only}
    1. Antunes I, Woronik V, Sabagga E, Machado MM, Barros RT. ACE inhibition reduces proteinuria, hematuria and renal expression of inflammatory mediators in human lupus nephritis [abstract]. Journal of the American Society of Nephrology 2001;12(Program & Abstracts):90A. [CENTRAL: CN‐00444198]
ASPEN 2008 {published data only}
    1. Linnik MD, Tansey MJ, Joh T. Dose dependent reduction in anti‐dsDNA antibody levels observed with abetimus sodium through 52 weeks in the phase 3 ASPEN study (abetimus sodium in patients with a history of lupus nephritis) [abstract no: 1077]. ACR/ARHP Annual Scientific Meeting; 2008 Oct 24‐29; San Francisco (CA). 2008.
    1. Tansey MJ, Joh T, Linnik MD. Interim analysis reveals dose dependent reduction in anti‐dsDNA antibody levels with Abetimus sodium through 52 weeks in the phase 3 ASPEN study (Abetimus Sodium in Patients with a history of lupus Nephritis) [abstract no: SA‐PO2958]. Journal of the American Society of Nephrology 2008;19(Abstracts issue):781A.
    1. Tansey MJ, Joh T, Linnik MD. Interim analysis reveals dose dependent reduction in anti‐dsDNA antibody levels with Abetimus sodium through 52 weeks in the phase 3 ASPEN study (Abetimus Sodium in patients with a History of lupus Nephritis) [abstract no: THU0237]. Annals of the Rheumatic Diseases 2009;68(Suppl 3):251.
ATLAS 2016 {published data only}
    1. Furie R, Malyar V. Efficacy, safety, and tolerability of BIIB023 as an adjunct to standard of care in subjects with lupus nephritis [abstract no: 749]. Arthritis & Rheumatology 2017;68(Suppl 10):749.
    1. Rovin B, Wofsy D, Jayne DR, Mysler E, Smirnakis K, Duffield JS, et al. Results from the ATLAS Trial: a phase 2 study to evaluate efficacy and safety of BIIB023 in subjects with lupus nephritis [abstract no:TH‐OR051]. Journal of the American Society of Nephrology 2016;27(Abstract Suppl):13A.
Austin 2009 {published and unpublished data}
    1. Austin HA III, Illei GG, Braun MJ, Balow JE. Randomized, controlled trial of prednisone, cyclophosphamide, and cyclosporine in lupus membranous nephropathy. Journal of the American Society of Nephrology 2009;20(4):901‐11. [MEDLINE: ] - PMC - PubMed
    1. Austin HA, Balow JE. Long‐term observations in a prospective clinical trial of prednisone, cyclosporine and cyclophosphamide for lupus membranous nephropathy (LMN) [abstract no: SU‐FO048]. Journal of the American Society of Nephrology 2004;15(Oct):54A.
    1. Austin HA, Vaughan EM, Balow JE. Lupus membranous nephropathy: randomized controlled trial of prednisolone, cyclosporine and cyclophosphamide [abstract no: A0439]. Journal of the American Society of Nephrology 2000;11:81A. - PMC - PubMed
    1. Austin HA, Vaughan EM, Boumpas DT, Klippel JH, Balow JE. Lupus membranous nephropathy: controlled trial of prednisolone, pulse cyclophosphamide, and cyclosporine A [abstract no: A0411]. Journal of the American Society of Nephrology 1996;7(9):1328.
Balow 1981 {published data only}
    1. Balow JE, Dinant HJ, Decker JL, Klippel JH, Plotz PH, Steinberg AD. Clinical trial of cyclophosphamide plus azathioprine and pulse cyclophosphamide in lupus nephritis [abstract]. Kidney International 1981;19:119.
Balow 1984 {published data only}
    1. Balow J, Austin H, Muenz L, Joyce K, Klippel J, Antonovych T. Influence of treatment on the evolution of renal pathology in lupus nephritis [abstract]. Kidney International 1984;25(1):158.
Ble 2011 {published data only}
    1. Ble A, Mosca M, Loreto G, Guglielmotti A, Biondi G, Bombardieri S, et al. Antiproteinuric effect of chemokine C‐C motif ligand 2 inhibition in subjects with acute proliferative lupus nephritis. American Journal of Nephrology 2011;34(4):367‐72. [MEDLINE: ] - PubMed
Chanchairujira 2009 {published data only}
    1. Chanchairujira T, Mahasukont J, Shayakul C, Ong‐Aj‐Yooth L, Cheunsuchon B, Parichaitiranond P. Histopathological outcome in proliferative lupus nephritis patients who did not achieve good response after randomized to eurolupus or high‐dose IV cyclophosphamide [abstract no: TH‐PO861]. Journal of the American Society of Nephrology 2009;20:309A.
Clark 1993 {published and unpublished data}
    1. Clark WF, Parbtani A, Naylor CD, Levinton CM, Muirhead N, Spanner E, et al. Fish oil in lupus nephritis: clinical findings and methodological implications. Kidney International 1993;44(1):75‐86. [MEDLINE: ] - PubMed
    1. Clark WF, Parbtani A, Naylor CD, Muirhead N, Huff MW, Philbrick DJ, et al. Fish oil in lupus nephritis a double‐blind randomized crossover study [abstract no: 37P]. Journal of the American Society of Nephrology 1992;3(3):309.
Clark 2001a {published and unpublished data}
    1. Clark WF, Kortas C, Heidenheim AP, Garland J, Spanner E, Parbtani A. Flaxseed in lupus nephritis: a two‐year nonplacebo‐controlled crossover study. Journal of the American College of Nutrition 2001;20(2 Suppl):143‐8. [MEDLINE: ] - PubMed
    1. Clark WF, Parbtani A, Macdonald G, Heidenheim P, Holub B, Kortas C. Flaxseed in lupus nephritis: a two year randomized cross‐over study [abstract no: T141]. Journal of the American Society of Nephrology 1998;9(Program & Abstracts):143A.
CONTROL 2016 {published data only}
    1. Anutrakulchai S, Panaput T, Wongchinsri J, Chaishayanon S, Satirapoj B, Traitanon O, et al. A multicentre, randomised controlled study of enteric‐coated mycophenolate sodium for the treatment of relapsed or resistant proliferative lupus nephritis: an Asian experience. Lupus Science & Medicine 2016;3(1):e000120. [MEDLINE: ] - PMC - PubMed
Davis 1999 {published data only}
    1. Davis JC, Manzi S, Yarboro C, Rairie J, Mcinnes I, Averthelyi D, et al. Recombinant human Dnase I (rhDNase) in patients with lupus nephritis. Lupus 1999;8(1):68‐76. - PubMed
Daza 2005 {published data only}
    1. Daza L, Kornhauser C, Zamora L, Flores J. Captopril effect on prostaglandin E2, thromboxane B2 and proteinuria in lupus nephritis patients. Prostaglandins & Other Lipid Mediators 2005;78(1‐4):194‐201. - PubMed
Deng 2017a {published and unpublished data}
    1. Deng D, Zhang P, Guo Y, Lim TO. A randomised double‐blind, placebo‐controlled trial of allogeneic umbilical cord‐derived mesenchymal stem cell for lupus nephritis. Annals of the Rheumatic Diseases 2017;76(8):1436‐9. [MEDLINE: ] - PubMed
Feng 2014 {published data only}
    1. Feng X, Gu F, Chen W, Liu Y, Wei H, Liu L, et al. Mizoribine versus mycophenolate mofetil or intravenous cyclophosphamide for induction treatment of active lupus nephritis. Chinese Medical Journal 2014;127(21):3718‐23. [MEDLINE: ] - PubMed
Frutos 1997 {published data only}
    1. Frutos MA, Valera A, Martinez JM, Martin‐Reyes G, Lopez de Novales E. Intravenous cyclophosphamide pulse therapy for severe lupus nephritis: finding an optimal dose and duration [abstract no: P1614]. Nephrology 1997;3(Suppl 1):S476.
Hebert 1987 {published data only}
    1. Hebert I, Nielsen E, Pohl M, Lachin J, Hunsicker L, Lewis E. Clinical course of severe lupus nephritis during the controlled clinical trial of plasmapheresis [abstract]. Kidney International 1987;31(1):201.
Khajehdehi 2012 {published data only}
    1. Khajehdehi P, Zanjaninejad B, Aflaki E, Nazarinia M, Azad F, Malekmakan L, et al. Oral supplementation of turmeric decreases proteinuria, hematuria, and systolic blood pressure in patients suffering from relapsing or refractory lupus nephritis: a randomized and placebo‐controlled study. Journal of Renal Nutrition 2012;22(1):50‐7. [MEDLINE: ] - PubMed
Kuo 2001 {published data only}
    1. Kuo GM, Boumpas DT, Illei GG, Yarboro C, Pucino F, Burstein AH. Fludarabine pharmacokinetics after subcutaneous and intravenous administration in patients with lupus nephritis. Pharmacotherapy 2001;21(5):528‐33. [MEDLINE: ] - PubMed
Li 2005 {published data only}
    1. Li L, Zhang H, Shen S, Hu W, Liu Z. Controlled trial of tacrolimus (FK506) vs intravenous cyclophosphamide (IVC) as induction therapy for severe lupus nephritis [abstract no: F‐PO1006]. Journal of the American Society of Nephrology 2005;16:556A.
Li 2014a {published data only}
    1. Li M, Ma JJ, Zhao XL, Zhu Y. Treating lupus nephritis by a drug pair of radix astragali and rehmanniae radix combined with glucocorticoid: a preliminary clinical study. Zhongguo Zhongxiyi Jiehe Zazhi [Chinese Journal of Integrated Traditional and Western Medicine] 2014;34(8):956‐9. [MEDLINE: ] - PubMed
LJP 394‐90‐05 2003 {published data only}
    1. Alarcon‐Segovia D, Tumlin J, Furie R, McKay J, Cariel M, Linnik M, et al. SLE trial shows fewer renal flares in LJP 394‐treated patients with high affinity antibodies to LJP 394: 90‐05 trial results [abstract]. Arthritis & Rheumatism 2000;43:S272.
    1. Alarcon‐Segovia D, Tumlin JA, Furie RA, McKay JD, Cardiel MH, Strand V, et al. LJP 394 for the prevention of renal flare in patients with systemic lupus erythematosus: results from a randomized, double‐blind, placebo‐controlled study. Arthritis & Rheumatism 2003;48(2):442‐54. [MEDLINE: ] - PubMed
    1. Hura C, Tumlin JA, Heilbrunn KR. Integrated safety results from studies of LJP394 in SLE patients [abstract no: F‐PO218]. Journal of the American Society of Nephrology 2004;15(Oct):113A.
    1. Linnik MD, Hu JZ, Heilbrunn KR, Strand V, Hurley FL, Joh T. Anti‐dsDNA antibodies and exacerbation of renal disease in patients with systemic lupus erythematosus: results from 2 randomized controlled trials with LJP394 [abstract]. Lupus 2004; 7th International Congress on SLE and Related Conditions; 2004 May 9‐13; New York (NY). 2004.
    1. Linnik MD, Hu JZ, Heilbrunn KR, Strand V, Hurley FL, Joh T, et al. Relationship between anti‐double‐stranded DNA antibodies and exacerbation of renal disease in patients with systemic lupus erythematosus. Arthritis & Rheumatism 2005;52(4):1129‐37. [MEDLINE: ] - PubMed
LJP 394‐90‐09 2005 {published and unpublished data}
    1. Cardiel MH, LJP 394‐90‐09 Study Investigators. Randomized, placebo controlled, double blind phase III trial for the evaluation of LJP 394 (Abetimus sodium) in the treatment of patients with SLE who are at risk of renal flare [abstract no: OP0053]. Annual European Congress of Rheumatology EULAR; 2003 June 18‐21; Lisbon (Portugal). 2003.
    1. Cardiel MH, Tumlin JA, Furie RA, Wallace DJ, Joh T, Linnik MD, et al. Abetimus sodium for renal flare in systemic lupus erythematosus: results of a randomized, controlled phase III trial. Arthritis & Rheumatism 2008;58(8):2470‐80. [MEDLINE: ] - PubMed
    1. Hura C, Tumlin JA, Heilbrunn KR. Integrated safety results from studies of LJP394 in SLE patients [abstract no: F‐PO218]. Journal of the American Society of Nephrology 2004;15(Oct):113A.
    1. Linnik MD, Hu JZ, Heilbrunn KR, Strand V, Hurley FL, Joh T. Anti‐dsDNA antibodies and exacerbation of renal disease in patients with systemic lupus erythematosus: results from 2 randomized controlled trials with LJP394 [abstract]. Lupus 2004; 7th International Congress on SLE and Related Conditions; 2004 May 9‐13; New York (NY). 2004.
    1. Linnik MD, Hu JZ, Heilbrunn KR, Strand V, Hurley FL, Joh T, et al. Relationship between anti‐double‐stranded DNA antibodies and exacerbation of renal disease in patients with systemic lupus erythematosus. Arthritis & Rheumatism 2005;52(4):1129‐37. [MEDLINE: ] - PubMed
Lu 2002 {published data only}
    1. Lu L. Study on effect of Cordyceps sinensis and artemisinin in preventing recurrence of lupus nephritis. Zhongguo Zhongxiyi Jiehe Zazhi [Chinese Journal of Integrated Traditional and Western Medicine] 2002;22(3):169‐71. [MEDLINE: ] - PubMed
Miyasaka 2009 {published data only}
    1. Miyasaka N, Kawai S, Hashimoto H. Efficacy and safety of tacrolimus for lupus nephritis: a placebo‐controlled double‐blind multicenter study. Modern Rheumatology 2009;19(6):606‐15. [MEDLINE: ] - PubMed
NCT00001212 {published data only}
    1. NCT00001212. Immunosuppressive drug therapy in membranous lupus nephropathy. www.clinicaltrials.gov/ct2/show/NCT00001212 (first received 3 November 1999).
NCT00404157 {published data only}
    1. Garg J. A study to evaluate the safety of rituximab retreatment in subjects with lupus nephritis previously enrolled in study U2970g. www.clinicalTrials.gov/show/NCT00404157 (first received 27 November 2006).
NCT00429377 {published data only}
    1. NCT00429377. Phase 3 study of tacrolimus (FK506) for lupus nephritis: a placebo controlled, double‐blind multicenter, comparative study. www.clinicaltrials.gov/ct2/show/NCT00429377 (first received 29 January 2007).
NCT00436438 {published data only}
    1. NCT00425438. A randomized, open‐label study to compare the effect of cellcept plus corticosteroids, and cyclophosphamide plus corticosteroids followed by azathioprine, on remission rate in patients with lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT00425438 (first received 23 January 2007).
NCT00539799 {unpublished data only}
    1. Jayne D, Walsh M. Corticosteroids in the maintenance therapy of proliferative lupus nephritis: a randomized pilot study (SIMPL). www.clinicaltrials.gov/ct2/show/NCT00539799 (first received 4 October 2007).
NCT00659217 {published and unpublished data}
    1. Tan JM. Effect of mesenchymal stem cell transplantation for lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT00659217 (first received 14 April 2008).
NCT01299922 {published data only}
    1. Praga M, Gema FJ. Phase III, open, randomized, parallel‐group clinical trial, to evaluate the efficacy and safety of treatment with prednisone, cyclosporine, mycophenolic acid versus prednisone and mycophenolic acid in lupus nephritis type III‐IV‐V. www.clinicaltrials.gov/ct2/show/NCT01299922 (first received 18 February 2011).
NCT01342016 {published data only}
    1. NCT01342016. A randomized, double‐blind double dummy, parallel control and multi‐center clinical trial to compare the efficacy and safety of tacrolimus capsules in treatment of lupus nephritis with leflunomide tablets. www.clinicaltrials.gov/ct2/show/NCT01342016 (first received 25 April 2011).
NCT01930890 {published data only}
    1. NCT01930890. BIIB023 long‐term extension study in subjects with lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT01930890 (first received 29 August 2013).
NCT02176486 {published data only}
    1. NCT02176486. A phase 1b, randomized, double‐blind, placebo‐controlled, safety, tolerability and pharmacokinetic study of multiple rising doses of MLN9708 for the treatment of subjects with ISN/RPS class III or IV lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02176486 (first received 25 June 2014).
Pierucci 1989 {published data only}
    1. Pierucci A, Simonetti BM, Pecci G, Feriozzi S, Mavrikakis G, Cinotti GA, et al. Low does aspirin in patients with lupus nephritis [abstract]. Kidney International 1988;33(1):281.
    1. Pierucci A, Simonetti BM, Pecci G, Mavrikakis G, Feriozzi S, Cinotti GA, et al. Acute effects of a thromboxane receptor antagonist on renal function in patients with lupus nephritis [abstract]. Kidney International 1987;31(1):283.
    1. Pierucci A, Simonetti BM, Pecci G, Mavrikakis G, Feriozzi S, Cinotti GA, et al. Improvement of renal function with selective thromboxane antagonism in lupus nephritis. New England Journal of Medicine 1989;320(7):421‐5. [MEDLINE: ] - PubMed
Schaumann 1992 {published data only}
    1. Schaumann D, Hein R, Neumann KH, Brunkhorst R, Schmidt RE, Koch KM. Short term cyclophosphamide (CP) bolus therapy for lupus nephritis [abstract]. Journal of the American Society of Nephrology 1994;5(3):360A.
    1. Schaumann D, Hein R, Schmidt RE, Brunkhorst R, Neumann KH, Deicher H, et al. Intravenous cyclophosphamide (CP) pulse therapy for lupus nephritis ‐ duration of induction therapy [abstract no: 028]. International Symposium on Pathogenesis, Pathophysiology & Therapy of Glomerulonephritis; 1992 Dec 3‐5; Bruges, Belgium. 1992:60.
Su 2007 {published data only}
    1. Su L, Mao JC, Gu JH. Effect of intravenous drip infusion of cyclophosphamide with high‐dose Astragalus injection in treating lupus nephritis. Zhong Xi Yi Jie He Xue Bao [Journal of Chinese Integrative Medicine] 2007;5(3):272‐5. [MEDLINE: ] - PubMed
Sztejnbok 1971 {published data only}
    1. Sztejnbok M, Stewart A, Diamond H, Kaplan D. Azathioprine in the treatment of systemic lupus erythematosus. A controlled study. Arthritis & Rheumatism 1971;14(5):639‐45. - PubMed
Wallace 2006 {published data only}
    1. Wallace DJ, Lisse J, Stohl W, McKay J, Boling E, Merrill JT, et al. Belimumab (BmAb) reduces SLE disease activity and demonstrates durable bioactivity at 76 weeks [abstract no: 2012]. ACR/ARHP Annual Scientific Meeting; 2006 Nov 11‐15; Washington (DC). 2006.
Wang 2007 {published data only}
    1. Wang J, Hu W, Xie H, Zhang H, Chen H, Zeng C, et al. Induction therapies for class IV lupus nephritis with non‐inflammatory necrotizing vasculopathy: mycophenolate mofetil or intravenous cyclophosphamide. Lupus 2007;16(9):707‐12. [MEDLINE: ] - PubMed
Witte 1993 {published data only}
    1. Hein R, Neumann KH, Koch KM, Deicher H, Schmidt RE. Cyclophosphamide pulse therapy of systemic lupus erythematosus with renal involvement [Cyclophosphamid‐Stosstherapie des systemischen Lupus erythematodes mit Nierenbeteiligung]. Immunitat und Infektion 1991;19(2):57‐8. [MEDLINE: ] - PubMed
    1. Witte T, Schaumann D, Hein R, Helmchen U, Neumann KH, Koch KM, et al. Cyclophosphamide bolus therapy in lupus nephritis [Cyclophosphamid‐Bolustherapie bei Lupusnephritis]. Deutsche Medizinische Wochenschrift 1993;118(27‐28):1005‐10. [MEDLINE: ] - PubMed
    1. Witte T, Schaumann D, Hein R, Neumann KH, Koch KM, Deicher H, et al. Cyclophosphamide bolus therapy in lupus nephritis ‐ status of the clinical study [Cyclophosphamidbolus‐Therapie bei Lupusnephritis‐‐Stand der Therapiestudie]. Immunitat und Infektion 1993;21(Suppl 1):24‐6. [MEDLINE: ] - PubMed
Yap 2012 {published data only}
    1. Yap DY, Yu X, Chen XM, Lu F, Chen N, Li XW, et al. Pilot 24 month study to compare mycophenolate mofetil and tacrolimus in the treatment of membranous lupus nephritis with nephrotic syndrome. Nephrology 2012;17(4):352‐7. [MEDLINE: ] - PubMed
Ye 2001 {published data only}
    1. Ye Z, Tan YH, Hong XP, Feng XX, Xiao XL. MMF vs CTX in the treatment of severe SLE patients [abstract no: P1610]. Lupus 2001;10(Suppl):S99.
Yoshida 1996 {published data only}
    1. Yoshida T, Kameda H, Ichikawa Y, Tojo T, Homma M. Improvement of renal function with a selective thromboxane A2 synthetase inhibitor, DP‐1904, in lupus nephritis. Journal of Rheumatology 1996;23(10):1719‐24. [MEDLINE: ] - PubMed
    1. Yoshida T, Kameda H, Masashi A, Homma M, Ikeda Y. Improvement of renal function with selective thromboxane A2 synthetase inhibitor, DP‐1904 in lupus nephritis. Advances in Experimental Medicine & Biology 1997;433:113‐7. [MEDLINE: ] - PubMed
Zhang 2015c {published and unpublished data}
    1. Zhang J, Zhao Z, Hu X. Effect of Rituximab on serum levels of anti‐C1q and antineutrophil cytoplasmic autoantibodies in refractory severe lupus nephritis. Cell Biochemistry & Biophysics 2015;72(1):197‐201. [MEDLINE: ] - PubMed
Zheng 2005a {published data only}
    1. Zheng WC, Hu SJ, Fang Q. Intervention of liuwei dihuang pill on lupus nephropathy treated with cyclophosphamide and glucocorticoids. Zhongguo Zhongxiyi Jiehe Zazhi [Chinese Journal of Integrated Traditional and Western Medicine] 2005;25(11):983‐5. - PubMed

References to ongoing studies

2nd Dutch Lupus Trial {published data only}
    1. Bijl M. Comparison of short course cyclophosphamide followed by mycophenolate mofetil versus long course cyclophosphamide in the treatment of proliferative lupus nephritis. www.controlled‐trials.com/ISRCTN34634478 (first received 27 January 2006).
ChiCTR‐TRC‐09000587 {published data only}
    1. Li Z. The intensive therapy of severe lupus nephritis: a multicenter, randomized, controlled prospective clinical trial. www.chictr.org.cn/showprojen.aspx?proj=8948 (first received 1 October 2009).
ChiCTR‐TRC‐10000931 {published data only}
    1. Mei C. Treatment of severe lupus nephritis with tacrolimus (FK 506) based immunosuppression. www.chictr.org.cn/showprojen.aspx?proj=8607 (first received 9 July 2010).
CTRI/2016/01/006488 {published data only}
    1. Gupta KL. Comparison of two steroid dose regimen in lupus nephritis. www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=13735&EncHid... (first received 7 January 2016).
CTRI/2017/05/008697 {published data only}
    1. Gupta KL. A study to compare the efficacy of cyclophosphamide versus multi‐drug therapy in the treatment of lupus nephritis. www.ctri.nic.in/Clinicaltrials/showallp.php?mid1=19083&EncHid=&u... (first received 30 May 2017).
ISRCTN66475575 {published data only}
    1. Chartapisak W. Enteric coat mycophenolate sodium versus intravenous cyclophosphamide for severe paediatric lupus nephritis. www.isrctn.com/ISRCTN66475575 (first received 29 July 2009).
NCT00302549 {published data only}
    1. Li LS. To compare the efficacy and safety of FK506 vs IVC in the treatment of class III‐IV LN. www.clinicaltrials.gov/ct2/show/NCT00302549 (first received 14 March 2006).
NCT00705367 {published data only}
    1. NCT00705367. Phase I study in China ‐ tolerability of a single dose of abatacept 30 mg/kg. www.clinicaltrials.gov/show/NCT00705367 (first received 26 June 2008).
NCT00881309 {published data only}
    1. Hu W. To compare the efficacy and safety of tripterygium (TW) vs AZA in the maintenance therapy for lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT00881309 (first received 14 April 2009).
NCT01056237 {published data only}
    1. Liu ZH. Long‐term study of multi‐target therapy as maintenance treatment for lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT01056237 (first received 26 January 2010).
NCT01172002 {published data only}
    1. NCT01172002. A randomized multicenter trial comparing leflunomide and azathioprine as remission‐maintaining treatment for proliferative lupus glomerulonephritis. www.clinicaltrials.gov/ct2/show/NCT01172002 (first received 27 July 2010).
NCT01284725 {published data only}
    1. Belaigues, B. Weaning of Immunosuppression in Nephritis of Lupus (WIN‐Lupus). www.clinicaltrials.gov/ct2/show/NCT01284725 (first received 21 January 2011).
NCT01639339 {published data only}
    1. NCT01639339. A phase 3, randomized, double‐blind, placebo‐controlled study to evaluate the efficacy and safety of belimumab plus standard of care versus placebo plus standard of care in adult subjects with active lupus nephritis (BLISS‐LN). www.clinicaltrials.gov/ct2/show/NCT01639339 (first received 10 July 2012).
NCT01714817 {published data only}
    1. NCT01714817. Efficacy and safety study of abatacept to treat lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT01714817 (first received 26 October 2012).
NCT01845740 {published data only}
    1. Wegener W. Phase Ib study of SC milatuzumab in SLE. www.clinicaltrials.gov/ct2/show/NCT01845740 (first received 3 May 2013).
NCT01861561 {published data only}
    1. Piyaphanee N, Pattaragarn A. Efficacy and infectious complications of induction therapy with low‐dose versus high‐dose intravenous cyclophosphamide for proliferative lupus nephritis in children. www.clinicaltrials.gov/ct2/show/NCT01861561 (first received 19 May 2013).
NCT02226341 {published data only}
    1. NCT02226341. Open‐label prospective randomized study to determine the efficacy and safety of two dosing regimens of ACTHar in the treatment of proliferative lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02226341 (first received 25 August 2014).
NCT02256150 {published data only}
    1. NCT02256150. A multi‐center, randomized, controlled, open‐label clinical study to evaluate the efficacy and safety of mizoribine in comparison with cyclophosphamide in the treatment of lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02256150 (first received 1 October 2014).
NCT02260934 {published data only}
    1. Diamond B, Wofsy D, Dall'Era M, Aranow C. Rituximab plus cyclophosphamide followed by belimumab for the treatment of lupus nephritis (ITN055AI) (CALIBRATE). www.clinicaltrials.gov/ct2/show/NCT02260934 (first received 6 October 2014).
NCT02457221 {published data only}
    1. NCT02457221. A phase III, randomized, open, parallel‐controlled, multi‐center study to compare the efficacy and safety of tacrolimus capsules and cyclophosphamide injection in treatment of lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02457221 (first received 22 May 2015).
NCT02547922 {published data only}
    1. NCT02547922. A multicentre, randomised, double‐blind, placebo‐controlled, phase 2 study evaluating the efficacy and safety of anifrolumab in adult subjects with active proliferative lupus nephritis (TULIP‐LN1). www.clinicaltrials.gov/ct2/show/NCT02547922 (first received 31 August 2015).
NCT02550652 {published data only}
    1. NCT02550652. A randomized, double‐blind, placebo‐controlled, multi‐center study to evaluate the safety and efficacy of obinutuzumab in subjects with ISN/RPS 2003 class III or IV lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02550652 (first received 14 September 2015).
NCT02630628 {published data only}
    1. Chan DT. A randomized open‐label study to evaluate the efficacy and safety of tacrolimus and corticosteroids in comparison with mycophenolate mofetil and corticosteroids in subjects with class III/IV±V lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02630628 (first received 5 December 2015).
NCT02770170 {published data only}
    1. NCT02770170. A double‐blind, randomised, placebo‐controlled trial evaluating the effect of BI 655064 administered as sub‐cutaneous injections, on renal response after one year treatment in patients with lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02770170 (first received 11 May 2016).
NCT02936375 {published data only}
    1. Bao C. Iguratimod as treatment for active lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02936375 (first received12 October 2016).
NCT02954939 {published data only}
    1. Yap D. A randomized, controlled double‐blind study comparing the efficacy and safety of orelvo (voclosporin) (23.7 mg twice daily) with placebo in achieving renal response in subjects with active lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT02954939 (first received 13 September 2016).
NCT03021499 {published data only}
    1. Dooley MA. Aurinia renal response in active lupus with voclosporin. www.clinicaltrials.gov/ct2/show/NCT03021499 (first received 16 January 2017).
NCT03214731 {published data only}
    1. Yu XQ. Efficacy and safety of artesunate plus standard of care in active lupus nephritis. www.clinicaltrials.gov/ct2/show/NCT03214731 (first received 12 July 2017).
PER‐062‐15 {published data only}
    1. PER‐062‐15. A multicentre, randomised, double‐blind, placebo‐controlled, phase 3 study evaluating the efficacy and safety of two doses of anifrolumab in adult subjects with active proliferative lupus nephritis. www.ins.gob.pe/ensayosclinicos/rpec/recuperarECPBNuevoEN.asp?numec=062‐15 (first received 4 May 2016).
RING 2015 {published data only}
    1. Houssiau FA. RING, an investigator‐initiated trial aimed at testing the efficacy of rituximab in refractory lupus nephritis: rationale, trial design and call for participation [abstract]. Clinical & Experimental Rheumatology 2015;33(3 Suppl 90):S30. [EMBASE: 71976757; NCT01673295]
RITUXILUP 2013 {published data only}
    1. Lightstone L. Phase 3 open label randomised multicentre controlled trial of rituximab and mycophenolate mofetil without oral steroids for the treatment of lupus nephritis (RITUXILUP). www.clinicaltrials.gov/ct2/show/NCT01773616 (first received 23 January 2013).

Additional references

Adler 2006
    1. Adler M, Chambers S, Edwards C, Neild G, Isenberg D. An assessment of renal failure in an SLE cohort with special reference to ethnicity, over a 25‐year period. Rheumatology 2006;45(9):1144‐7. [MEDLINE: ] - PubMed
ANZDATA 2016
    1. Australia, New Zealand Dialysis, Transplant Registry. ANZDATA Registry. 39th Report, Chapter 1: Incidence of End Stage Kidney Disease. www.anzdata.org.au/anzdata/AnzdataReport/39thReport/c01_incidence_v5.0_2... (accessed 17 May 2018).
Bansal 1997
    1. Bansal VK, Beto JA. Treatment of lupus nephritis: a meta‐analysis of clinical trials. American Journal of Kidney Diseases 1997;29(2):193‐9. - PubMed
Begg 1996
    1. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 1996;276(8):637‐9. [MEDLINE: ] - PubMed
Cao 2015
    1. Cao H, Rao Y, Liu L, Lin J, Yang H, Zhang X, et al. The efficacy and safety of leflunomide for the treatment of lupus nephritis in Chinese patients: systematic review and meta‐analysis. PLoS ONE [Electronic Resource] 2015;10(12):e0144548. [MEDLINE: ] - PMC - PubMed
Cervera 2009
    1. Cervera R, Khamashta MA, Hughes GR. The Euro‐lupus project: epidemiology of systemic lupus erythematosus in Europe. Lupus 2009;18(10):869‐74. [MEDLINE: ] - PubMed
Chen 2017
    1. Chen Y, Sun J, Zou K, Yang Y, Lin G. Treatment for lupus nephritis: an overview of systematic reviews and meta‐analyses. Rheumatology International 2017;37(7):1089‐99. [MEDLINE: ] - PubMed
Contreras 2006
    1. Contreras G, Lenz O, Pardo V, Borja E, Cely C, Iqbal K, et al. Outcomes in African Americans and Hispanics with lupus nephritis. Kidney International 2006;69(10):1846‐51. [MEDLINE: ] - PubMed
Costenbader 2011
    1. Costenbader KH, Desai A, Alarcon GS, Hiraki LT, Shaykevich T, Brookhart MA, et al. Trends in the incidence, demographics, and outcomes of end‐stage renal disease due to lupus nephritis in the US from 1995 to 2006. Arthritis & Rheumatism 2011;63(6):1681‐8. [MEDLINE: ] - PMC - PubMed
Daleboudt 2011
    1. Daleboudt GM, Berger SP, Broadbent E, Kaptein AA. Health‐related quality of life in patients with systemic lupus erythematosus and proliferative lupus nephritis. Psychology Health & Medicine 2011;16(4):393‐404. [MEDLINE: ] - PubMed
Deeks 2001
    1. Deeks JJ. Systematic reviews in health care: Systematic review of evaluations of diagnostic and screening tests. BMJ 2001;323(7305):157‐62. [PUBMED: 11463691] - PMC - PubMed
Deng 2012
    1. Deng J, Huo D, Wu Q, Yang Z, Liao Y. A meta‐analysis of randomized controlled trials comparing tacrolimus with intravenous cyclophosphamide in the induction treatment for lupus nephritis. Tohoku Journal of Experimental Medicine 2012;227(4):281‐8. [MEDLINE: ] - PubMed
Dooley 1997
    1. Dooley MA, Hogan S, Jenette C, Falk R. Cyclophosphamide therapy for lupus nephritis: poor renal survival in black Americans. Glomerular Disease Collaborative Network. Kidney International 1997;51(4):1188‐95. [MEDLINE: ] - PubMed
Feng 2013
    1. Feng L, Deng J, Huo DM, Wu QY, Liao YH. Mycophenolate mofetil versus azathioprine as maintenance therapy for lupus nephritis: a meta‐analysis. Nephrology 2013;18(2):104‐10. [MEDLINE: ] - PubMed
Fernandes das Neves 2015
    1. Fernandes das Neves M, Irlapati RV, Isenberg D. Assessment of long‐term remission in lupus nephritis patients: a retrospective analysis over 30 years. Rheumatology 2015;54(8):1403‐7. [MEDLINE: ] - PubMed
GRADE 2008
    1. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck‐Ytter Y, Alonso‐Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924‐6. [MEDLINE: ] - PMC - PubMed
GRADE 2011
    1. Guyatt GH, Oxman AD, Schunemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. Journal of Clinical Epidemiology 2011;64(4):380‐2. [MEDLINE: ] - PubMed
Hanly 2016
    1. Hanly JG, O'Keeffe AG, Su L, Urowitz MB, Romero‐Diaz, Gordon C, et al. The frequency and outcome of lupus nephritis: results from an international inception cohort study. Rheumatology 2016;55(2):252‐62. [MEDLINE: ] - PMC - PubMed
Hannah 2016
    1. Hannah J, Casian A, D'Cruz D. Tacrolimus use in lupus nephritis: a systematic review and meta‐analysis. Autoimmunity Reviews 2016;15(1):93‐101. [MEDLINE: ] - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. [MEDLINE: ] - PMC - PubMed
Higgins 2011
    1. Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. 2011. Available from www.cochrane‐handbook.org.
Houssiau 2010
    1. Houssiau FA, Vasconcelos C, D'Cruz D, Sebastiani GD, Ramon Garrido E, Danieli MG, et al. The 10‐year follow‐up data of the Euro‐Lupus Nephritis Trial comparing low‐dose and high‐dose intravenous cyclophosphamide. Annals of the Rheumatic Diseases 2010;69(1):61‐4. [MEDLINE: ] - PubMed
Ioannidis 2000
    1. Ioannidis JP, Boki KA, Katsorida ME, Drosos AA, Skopouli FN, Boletis JN, et al. Remission, relapse, and re‐remission of proliferative lupus nephritis treated with cyclophosphamide. Kidney International 2000;57(1):258‐64. [MEDLINE: ] - PubMed
Isenberg 2010
    1. Isenberg D, Appel GB, Contreras G, Dooley MA, Ginzler EM, Jayne D, et al. Influence of race/ethnicity on response to lupus nephritis treatment: the ALMS study. Rheumatology 2010;49(1):128‐40. [MEDLINE: ] - PMC - PubMed
Kamanamool 2010
    1. Kamanamool N, McEvoy M, Attia J, Ingsathit A, Ngamjanyaporn P, Thakkinstian A. Efficacy and adverse events of mycophenolate mofetil versus cyclophosphamide for induction therapy of lupus nephritis: systematic review and meta‐analysis. Medicine 2010;89(4):227‐35. [MEDLINE: ] - PubMed
Korbet 2007
    1. Korbet SM, Schwartz MM, Evans J, Lewis EJ, Collaborative Study Group. Severe lupus nephritis: racial differences in presentation and outcome. Journal of the American Society of Nephrology 2007;18(1):244‐54. [MEDLINE: ] - PubMed
Lee 2010
    1. Lee Y, Woo JH, Choi SJ, Ji JD, Song GG. Induction and maintenance therapy for lupus nephritis: a systematic review and meta‐analysis. Lupus 2010;19(6):703‐10. [MEDLINE: ] - PubMed
Lee 2011
    1. Lee YH, Lee HS, Choi SJ, Dai Ji J, Song GG. Efficacy and safety of tacrolimus therapy for lupus nephritis: a systematic review of clinical trials. Lupus 2011;20(6):636‐40. [MEDLINE: ] - PubMed
Lee 2015
    1. Lee YH, Song GG. Relative efficacy and safety of tacrolimus, mycophenolate mofetil, and cyclophosphamide as induction therapy for lupus nephritis: a Bayesian network meta‐analysis of randomized controlled trials. Lupus 2015;24(14):1520‐8. [MEDLINE: ] - PubMed
Liang 2006
    1. Renal Disease Subcommittee of the American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Response, Criteria. The American College of Rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials. Arthritis & Rheumatism 2006;54(2):421‐32. [MEDLINE: ] - PubMed
Liu 2012
    1. Liu LL, Jiang Y, Wang LN, Yao L, Li ZL. Efficacy and safety of mycophenolate mofetil versus cyclophosphamide for induction therapy of lupus nephritis: a meta‐analysis of randomized controlled trials. Drugs 2012;72(11):1521‐33. [MEDLINE: ] - PubMed
Mak 2009
    1. Mak A, Cheak AA, Tan JY, Su HC, Ho RC, Lau CS. Mycophenolate mofetil is as efficacious as, but safer than, cyclophosphamide in the treatment of proliferative lupus nephritis: a meta‐analysis and meta‐regression. Rheumatology 2009;48(8):944‐52. [MEDLINE: ] - PubMed
Maneiro 2014
    1. Maneiro JR, Lopez‐Canoa N, Salgado E, Gomez‐Reino JJ. Maintenance therapy of lupus nephritis with mycophenolate or azathioprine: systematic review and meta‐analysis. Rheumatology 2014;53(5):834‐8. [MEDLINE: ] - PubMed
McElhone 2006
    1. McElhone K, Abbott J, Teh LS. A review of health related quality of life in systemic lupus erythematosus. Lupus 2006;15(10):633‐43. [MEDLINE: ] - PubMed
Mills 2013
    1. Mills EJ, Thorlund K, Ioannidis JP. Demystifying trial networks and network meta‐analysis. BMJ 2013;346:f2914. [MEDLINE: ] - PubMed
Moher 1999
    1. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta‐analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta‐analyses. Lancet 1999;354(9193):1896‐900. [MEDLINE: ] - PubMed
Mok 2002
    1. Mok CC, Ho CT, Chan KW, Lau CS, Wong RW. Outcome and prognostic indicators of diffuse proliferative lupus glomerulonephritis treated with sequential oral cyclophosphamide and azathioprine. Arthritis & Rheumatism 2002;46(4):1003‐13. [MEDLINE: ] - PubMed
Moore 2006
    1. Moore RA, Derry S. Systematic review and meta‐analysis of randomised trials and cohort studies of mycophenolate mofetil in lupus nephritis. Arthritis Research & Therapy 2006;8(6):R182. [MEDLINE: ] - PMC - PubMed
Moroni 2007
    1. Moroni G, Quaglini S, Gallelli B, Banfi G, Messa P, Ponticelli C. The long‐term outcome of 93 patients with proliferative lupus nephritis. Nephrology Dialysis Transplantation 2007;22(9):2531‐9. [MEDLINE: ] - PubMed
Murphy 2013
    1. Murphy G, Lisnevskaia L, Isenberg D. Systemic lupus erythematosus and other autoimmune rheumatic diseases: challenges to treatment. Lancet 2013;382(9894):809‐18. [MEDLINE: ] - PubMed
Palmer 2017
    1. Palmer SC, Tunnicliffe DJ, Singh‐Grewal D, Mavridis D, Tonelli M, Johnson DW, et al. Induction and maintenance immunosuppression treatment of proliferative lupus nephritis: a network meta‐analysis of randomized trials. American Journal of Kidney Disease 2017;70(3):324‐36. [MEDLINE: ] - PubMed
Ponticelli 1998
    1. Ponticelli C, Moroni G. Flares in lupus nephritis: incidence, impact on renal survival and management. Lupus 1998;7(9):635‐8. [MEDLINE: ] - PubMed
Radhakrishnan 2010
    1. Radhakrishnan J, Moutzouris DA, Ginzler EM, Solomons N, Siempos II, Appel GB. Mycophenolate mofetil and intravenous cyclophosphamide are similar as induction therapy for class V lupus nephritis. Kidney International 2010;77(2):152‐60. [MEDLINE: ] - PubMed
Rovin 2014
    1. Rovin BH, Parikh SV. Lupus nephritis: the evolving role of novel therapeutics. American Journal of Kidney Diseases 2014;63(4):677‐90. [MEDLINE: ] - PMC - PubMed
Schünemann 2011a
    1. Schünemann HJ, Oxman AD, Higgins JP, Vist GE, Glasziou P, Guyatt GH. Chapter 11: Presenting results and 'Summary of findings' tables. In: Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Schünemann 2011b
    1. Schünemann HJ, Oxman AD, Higgins JP, Deeks JJ, Glasziou P, Guyatt GH. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JP, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Sexton 2014
    1. Sexton DJ, Reule S, Solid C, Chen S, Collins AJ, Foley RN. ESRD from lupus nephritis in the United States. Clinical Journal of the American Society of Nephrology: CJASN 2014;10(2):251‐9. [MEDLINE: ] - PMC - PubMed
Singh 2016
    1. Singh JA, Hossain A, Kotb A, Oliveira A, Mudano AS, Grossman J, et al. Treatments for lupus nephritis: a systematic review and network metaanalysis. Journal of Rheumatology 2016;44(6):1801‐15. [MEDLINE: ] - PubMed
So 2011
    1. So MW, Koo BS, Kim YG, Lee CK, Yoo B. Predictive value of remission status after 6 months induction therapy in patients with proliferative lupus nephritis: a retrospective analysis. Clinical Rheumatology 2011;30(11):1399‐405. [MEDLINE: ] - PubMed
Strand 2000
    1. Stand V, Gladman D, Isenberg D, Petri M, Smolen J, Tugwell P. Endpoints: consensus recommendations from OMERACT IV. Outcome Measures in Rheumatology. Lupus 2000;9(5):322‐7. [MEDLINE: ] - PubMed
Sutanto 2013
    1. Sutanto B, Singh‐Grewal D, McNeil HP, O'Neill S, Craig JC, Jones J, et al. Experiences and perspectives of adults living with systemic lupus erythematosus: thematic synthesis of qualitative studies. Arthritis Care & Research 2013;65(11):1752‐65. [MEDLINE: ] - PubMed
Tektonidou 2016
    1. Tektonidou MG, Dasgupta A, Ward MM. Risk of end‐stage renal disease in patients with lupus nephritis, 1971‐2015: a systematic review and Bayesian meta‐analysis. Arthritis & Rheumatology 2016;68(6):1432‐41. [MEDLINE: ] - PMC - PubMed
Tench 2000
    1. Tench, CM, McCurdie I, White PD, D'Cruz DP. The prevalence and associations of fatigue in systemic lupus erythematosus. Rheumatology 2000;39(11):1249‐54. [MEDLINE: ] - PubMed
Tian 2014
    1. Tian SY, Feldman BM, Beyene J, Brown PE, Uleryk EM, Silverman ED. Immunosuppressive therapies for the induction treatment of proliferative lupus nephritis: a systematic review and network metaanalysis. Journal of Rheumatology 2014;41(10):1998‐2007. [MEDLINE: ] - PubMed
Tian 2015
    1. Tian SY, Feldman BM, Beyene J, Brown PE, Uleryk EM, Silverman ED. Immunosuppressive therapies for the maintenance treatment of proliferative lupus nephritis: a systematic review and network metaanalysis. Journal of Rheumatology 2015;42(8):1392‐400. [MEDLINE: ] - PubMed
Touma 2011
    1. Touma Z, Gladman DD, Urowitz MB, Beyene J, Uleryk EM, Shah PS. Mycophenolate mofetil for induction treatment of lupus nephritis: a systematic review and metaanalysis. Journal of Rheumatology 2011;38(1):69‐78. [MEDLINE: ] - PubMed
Tunnicliffe 2015
    1. Tunnicliffe DJ, Singh‐Grewal D, Kim S, Craig JC, Tong A. Diagnosis, monitoring, and treatment of systemic lupus erythematosus: a systematic review of clinical practice guidelines. Arthritis Care & Research 2015;67(10):1440‐52. [MEDLINE: ] - PubMed
van Vollenhoven 2017
    1. Vollenhoven R, Voskuyl A, Bertsias G, Aranow C, Aringer M, Arnaud L, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Annals of the Rheumatic Diseases 2017;76(3):554‐61. [MEDLINE: ] - PubMed
Vu 1999
    1. Vu TV, Escalante A. A comparison of the quality of life of patients with systemic lupus erythematosus with and without endstage renal disease. Journal of Rheumatology 1999;26(12):2595‐601. [MEDLINE: ] - PubMed
Walsh 2007
    1. Walsh M, James M, Jayne D, Tonelli M, Manns BJ, Hemmelgarn BR. Mycophenolate mofetil for induction therapy of lupus nephritis: a systematic review and meta‐analysis. Clinical Journal of the American Society of Nephrology: CJASN 2007;2(5):968‐75. [MEDLINE: ] - PubMed
Weidenbusch 2013
    1. Weidenbusch M, Rommele C, Schrottle A, Anders HJ. Beyond the LUNAR trial. Efficacy of rituximab in refractory lupus nephritis. Nephrology Dialysis Transplantation 2013;28(1):106‐11. [MEDLINE: ] - PubMed
Zakharova 2016
    1. Zakharova EV, Makarova TA, Zvonova EV, Anilina AM, Stolyarevich ES. Immunosuppressive treatment for lupus nephritis: long‐term results in 178 patients. BioMed Research International 2016:7407919. [MEDLINE: ] - PMC - PubMed
Zhang 2016
    1. Zhang X, Ji L, Yang L, Tang X, Qin W. The effect of calcineurin inhibitors in the induction and maintenance treatment of lupus nephritis: a systematic review and meta‐analysis. International Urology & Nephrology 2016;48(5):731‐43. [MEDLINE: ] - PubMed
Zhou 2011
    1. Zhou DJ, Wu XC. Meta‐analysis of calcineurin inhibitor in the treatment of lupus nephritis. Zhonghua Erke Zazh [Chinese Journal of Pediatrics] 2011;49(4):287‐93. [MEDLINE: ] - PubMed
Zhu 2007
    1. Zhu B, Chen N, Lin Y, Ren H, Zhang W, Wang W, et al. Mycophenolate mofetil in induction and maintenance therapy of severe lupus nephritis: a meta‐analysis of randomized controlled trials. Nephrology Dialysis Transplantation 2007;22(7):1933‐42. [MEDLINE: ] - PubMed

References to other published versions of this review

Flanc 2003
    1. Flanc R, Roberts M, Chadban S, Kerr P, Edworthy S, Atkins R. Treatment for lupus nephritis. Cochrane Database of Systematic Reviews 2003, Issue 4. [DOI: 10.1002/14651858.CD002922] - DOI - PubMed
Flanc 2004a
    1. Flanc RS, Roberts MA, Strippoli GF, Chadban SJ, Kerr PG, Atkins RC. Treatment for lupus nephritis. Cochrane Database of Systematic Reviews 2004, Issue 1. [DOI: 10.1002/14651858.CD002922.pub2] - DOI - PubMed
Flanc 2004b
    1. Flanc RS, Roberts MA, Strippoli GF, Chadban SJ, Kerr PG, Atkins RC. Treatment of diffuse proliferative lupus nephritis: a meta‐analysis of randomized controlled trials. American Journal of Kidney Diseases 2004;43(2):197‐208. [MEDLINE: ] - PubMed
Henderson 2012
    1. Henderson L, Masson P, Craig JC, Flanc RS, Roberts MA, Strippoli GF, et al. Treatment for lupus nephritis. Cochrane Database of Systematic Reviews 2012, Issue 12. [DOI: 10.1002/14651858.CD002922.pub3] - DOI - PubMed
Henderson 2013
    1. Henderson LK, Masson P, Craig JC, Roberts MA, Flanc RS, Strippoli GFM, et al. Induction and maintenance treatment of proliferative lupus nephritis: a meta‐analysis of randomized controlled trials. American journal of kidney diseases 2013;61(1):74‐87. [MEDLINE: ] - PubMed

Publication types

MeSH terms