IMMUNOSUPPRESSIVE TREATMENT IN LUPUS NEPHRITIS: A COMPARATIVE STUDY COMPARING THE EFFECT OF CYCLOPHOSPHAMIDE OR MYCOPHENOLATE IN NAIVE OR RELAPSING PATIENTS.

Background: Lupus nephritis, one of the most serious manifestations of systemic lupus erythematosus (SLE). Objective: The aim of the study is to compare the outcome of lupus nephritis patients regarding the achievement of complete or partial remission or failure of therapy after six and twelve months of induction therapy using two different immunosuppressive regimens in Egyptian patients. Methods: The study was conducted on eighty patients (40 naive and 40 relapsed) presented with lupus nephritis (Class III, IV and Class V) allocated from the National Institute of Nephrology and Urology (Cairo) and followed up for six and twelve months after induction therapy with two different immunosuppressive regimens (mycophenolate mofetil or cyclophosphamide). Renal response and complications were assessed after six and twelve months. Results: There was significant difference in patients who received either Cyclophosphamide or Mycophenolate mofetil regarding renal response in group B relapsing lupus nephritis patients after 6 month of therapy. There were eight (40%) patients with complete remission, four (20%) patients with partial remission, and only eight(40%) patients that had no remission with cyclophosphamide, whereas no patient who received mycophenolate mofetile entered complete remission, seven(35%) patients with partial remission, and 13(65%) patients that had no remission. while there was insignificant difference in group A na?ve lupus nephritis patients. Conclusion: we conclude the usage of cyclophosphamide in induction therapy for treating patients with relapsing lupus nephritis. Due to its superiority over mycophenolate mofetile in short term induction of remission while there was insignificant difference between the two drugs in na?ve patients.