LONG-TERM EFFICACY OF HIGH-DOSE INTRAVENOUS METHYLPREDNISOLONE PULSES IN ACTIVE LUPUS NEPHRITIS - A 21-MONTH PROSPECTIVE-STUDY

The efficacy of a single course of three high dose intravenous (IV) methylprednisolone (MP) pulses followed by low dose oral prednisone (PRED) was assessed in a group of patients with active lupus nephritis (LN). At 21 months after such therapeutic regimen in 10 out of 12 patients a complete clinical remission was found, in one patient a partial response with persistent moderate renal failure occurred, while one patient was refractory even to the additional administration of cyclophosphamide. The statistical analysis of repeated measures of a series of biological markers of LN, monitored over the course of the study, evidenced a significant improvement of serum creatinine (p < 0.05), C3 and C4 complement components (p <0.05), 24-hour proteinuria (p <0.02) and ESR values (p <0.05). Moreover, a progressive and significant reduction of mean daily PRED dosage was reported (p <0.05). We conclude that IV MP pulse therapy may exert a substantial long-term control of active LN and may induce steroid-sparing effects.