{"id":782,"date":"2013-08-05T16:35:30","date_gmt":"2013-08-05T16:35:30","guid":{"rendered":"http:\/\/promotions.bmj.com\/ardsummaries\/?p=14"},"modified":"2013-08-05T16:35:30","modified_gmt":"2013-08-05T16:35:30","slug":"potential-treatment-for-lupus-nephritis-without-oral-steroids","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/rheumsummaries\/2013\/08\/05\/potential-treatment-for-lupus-nephritis-without-oral-steroids\/","title":{"rendered":"Potential treatment for lupus nephritis without oral steroids"},"content":{"rendered":"<p><strong>INTRODUCTION<\/strong><\/p>\n<p>A small study of a new combination treatment for lupus nephritis that doesn\u2019t include oral steroids has shown\u00a0encouraging results. If larger studies show similar results, the new combination treatment could help people\u00a0with this condition avoid the side effects of long-term treatment with high doses of oral steroids.<\/p>\n<p><strong>WHAT DO WE KNOW ALREADY?<\/strong><\/p>\n<p>Lupus nephritis is inflammation, or swelling, in the kidneys that stops them working properly. It is a serious\u00a0complication of systemic lupus erythematosus (SLE), an autoimmune disease that can affect different organs\u00a0and parts of the body. In the UK, up to 60 in 100 adults with SLE are affected by lupus nephritis.<\/p>\n<p><!--more--><br \/>\nTreating lupus nephritis is not straightforward. The only drugs approved to treat it in the UK are aspirin, a\u00a0rheumatoid arthritis treatment called hydroxychloroquine, and corticosteroids (usually just called steroids),\u00a0which can help reduce swelling. But these don\u2019t help everyone. So doctors often prescribe treatments that\u00a0haven\u2019t been officially approved for people with lupus nephritis, but which work well.<\/p>\n<p>People who have lupus nephritis often have bouts of symptoms, called relapses, that last for weeks or\u00a0months, which means they need to have treatment for some time. However, taking oral steroids (steroid\u00a0tablets) for a long time, particularly the high doses needed to treat lupus nephritis, can cause serious side\u00a0effects and harm.<\/p>\n<p>In this study, researchers looked at using a different combination of medicines to treat lupus nephritis \u2013 one\u00a0that didn\u2019t include oral steroids. They looked at 50 people with SLE and lupus nephritis being treated in one\u00a0hospital in London, who were not taking oral steroids. All 50 people were given a combination of three different<br \/>\nmedicines, consisting of:<\/p>\n<ul>\n<li>Two infusions of rituximab (a type of medicine called a monoclonal antibody), and just two infusions of a\u00a0steroid called methyl prednisolone (instead of long-term oral steroids). These treatments were given directly\u00a0into the vein through a drip, during hospital appointments at the beginning of the study and then two weeks\u00a0later.<\/li>\n<li>Twice-daily tablets of mycophenolate mofetil, a treatment that affects the immune system, which people took\u00a0long-term.<\/li>\n<\/ul>\n<p>The researchers then measured how much people\u2019s symptoms improved after having treatment, and howmany had unwanted side effects or complications.<\/p>\n<p><strong>WHAT DOES THE NEW STUDY SAY?<\/strong><\/p>\n<p>During the study 45 of the 50 people had what the researchers called complete or partial remission of their\u00a0kidney symptoms. Complete remission meant that the kidneys were working much better than they were\u00a0before treatment started. Partial remission meant that the kidneys were working better than before treatment<br \/>\nstarted, but not as well as people in complete remission. The researchers followed up the people in the study\u00a0for an average of 37 weeks, but some people took longer than this to achieve partial or complete remission.<\/p>\n<p>Eleven people had relapses of their kidney symptoms and six had flare-ups of symptoms affecting other parts\u00a0of the body.<\/p>\n<p><strong>HOW RELIABLE ARE THE FINDINGS?<\/strong><\/p>\n<p>This study looked at how one small group of patients who took a treatment did over time. But there\u2019s a limit\u00a0to how much we can draw from a small study of this kind. We need larger studies that show how it compares\u00a0with other treatments.<\/p>\n<p><strong>WHAT DOES THIS MEAN FOR ME?<\/strong><\/p>\n<p>The researchers say that if larger, good-quality studies bear out these early results, it could lead to treatment\u00a0that would avoid the side effects and complications common with oral steroids. But it is unlikely doctors will\u00a0recommend this treatment until then.<\/p>\n<p>Copyright \u00a9 2015 BMJ Publishing Group Ltd &amp; European League Against Rheumatism. This information may be distributed without further permission for non-commercial use only.<\/p>\n<p dir=\"ltr\"><strong>Disclaimer<\/strong>: This is a summary of a scientific article written by a medical professional (\u201cthe Original Article\u201d). The Summary is written to assist non medically trained readers to understand general points of the Original Article. \u00a0<span style=\"text-decoration: underline\">It should not be relied on in any way whatsoever<\/span>, (which also means the Summary is not medical advice), and is simply supplied to aid a lay understanding of general points of the Original Article. It is supplied \u201cas is\u201d without any warranty. You should note that the Original Article (and Summary) may not be accurate as errors can occur and also may be out of date as medical science is constantly changing. \u00a0<strong>It is very important that readers not rely on the content in the Summary and consult their medical professionals for all aspects of their health care. Do not use this Summary as medical advice even if the Summary is supplied to the reader by a medical professional.<\/strong><br \/>\nPlease view our full <a href=\"http:\/\/www.bmj.com\/company\/legal-information\/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Website Terms and Conditions<\/a>.<\/p>\n<p>Date summary prepared:\u00a0August 2013<\/p>\n<p>Summary based on research article published on:\u00a05 June 2013<\/p>\n<p>From:\u00a0Condon, M. <em>et al<\/em>.\u00a0Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids.\u00a0<em>Ann Rheum Dis<\/em> 2013;72:1280-1286 <a href=\"http:\/\/ard.bmj.com\/content\/72\/8\/1280.full\">doi:10.1136\/annrheumdis-2012-202844<\/a><\/p>\n<p>Copyright \u00a9 2015 BMJ Publishing Group Ltd &amp; European League Against Rheumatism. Medical professionals may print copies for their and their patients and students non commercial use. Other individuals may print a single copy for their personal, non commercial use. For other uses please contact our <a href=\"http:\/\/www.bmj.com\/company\/products-services\/rights-and-licensing\/\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Rights and Licensing<\/a> Team.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION A small study of a new combination treatment for lupus nephritis that doesn\u2019t include oral steroids has shown\u00a0encouraging results. If larger studies show similar results, the new combination treatment could help people\u00a0with this condition avoid the side effects of long-term treatment with high doses of oral steroids. WHAT DO WE KNOW ALREADY? Lupus nephritis [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/rheumsummaries\/2013\/08\/05\/potential-treatment-for-lupus-nephritis-without-oral-steroids\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":384,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10,22],"tags":[],"class_list":["post-782","post","type-post","status-publish","format-standard","hentry","category-drug-treatment","category-lupus"],"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/782","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/users\/384"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/comments?post=782"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/posts\/782\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/media?parent=782"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/categories?post=782"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/rheumsummaries\/wp-json\/wp\/v2\/tags?post=782"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}