Clinical evaluation of efficacy of leflunomide combined with low-dose prednisone for treatment of myasthenia gravis

We conducted this randomized trial to investigate the efficacy and safety of rapamycin treatment in adults with chronic immune thrombocytopenia (ITP). Eighty-eight patients were separated into the control (cyclosporine A plus prednisone) and experimental (rapamycin plus prednisone) groups. The CD4+CD25+CD127lowregulatory T (Treg) cells level, Foxp3 mRNA expression, and the relevant cytokines levels were measured before and after treatment. The overall response (OR) was similar in both groups (experimental group versus control group: 58% versus 62%,P=0.70). However, sustained response (SR) was more pronounced in the experimental group than in the control group (68% versus 39%,P<0.05). Both groups showed similar incidence of adverse events (7% versus 11%,P=0.51). As expected, the low pretreatment baseline level of Treg cells was seen in all patients (P<0.001); however, the experimental group experienced a significant rise in Treg cell level, and there was a strong correlation between the levels of Treg cells and TGF-beta after the treatment. In addition, the upregulation maintained a stable level during the follow-up phase. Thus, rapamycin plus low dose prednisone could provide a new promising option for therapy of ITP.

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Recovery of the hypothalmic-pituitary adrenal (HPA) axis in patients with rheumatic diseases receiving low-dose prednisone

Journal of Oral and Maxillofacial Surgery ◽

10.1016/0278-2391(94)90422-7 ◽

1994 ◽

Vol 52 (2) ◽

pp. 203 ◽

Cited By ~ 1

Author(s):

R.H. Haug

Keyword(s):

Hpa Axis ◽

Rheumatic Diseases ◽

Low Dose ◽

Dose Prednisone

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Is mycophenolate mofetil combined with low-dose prednisone a treatment option for advanced IgA nephropathy? A 10-year follow-up case and brief literature review

European Journal of Inflammation ◽

10.1177/2058739218802680 ◽

2018 ◽

Vol 16 ◽

pp. 205873921880268

Author(s):

Qijun Wan ◽

Yongcheng He ◽

Hongtao Chen ◽

Hongping Liu ◽

Saodong Luan ◽

...

Keyword(s):

Mycophenolate Mofetil ◽

Iga Nephropathy ◽

Treatment Option ◽

Low Dose ◽

Interstitial Fibrosis ◽

Immunosuppressive Treatment ◽

Channel Blockers ◽

Tubular Atrophy ◽

Dose Prednisone

IgA nephropathy (IgAN) is now widely recognized as the most common primary glomerulonephritis worldwide, especially in China. The immunosuppressive treatment option for IgAN is still controversial. Previously, we proved that mycophenolate mofetil (MMF; Shanghai Roche, China) combined with low-dose prednisone was an effective and safe option for biopsy-proven mild to moderate IgAN patients in a short term of follow-up. This article we first reported the safety and efficacy of this regimen in a 42-year-old male biopsy-proven advanced 10-year follow-up IgAN case (Lee’s Class V; the patient was biopsied 10 years ago, so the Oxford Mesangial hypercellularity Endocapillary hypercellularity Segmental glomerulosclerosis Tubular atrophy/interstitial fibrosis (MEST) classification was not used). The mycophenolate and prednisone were only given for a limited time. The other main medications included calcium channel blockers and antiplatelet agents. Clinical and laboratory indexes were aperiodic assessed during the 10-year follow-up. The serum creatinine decreased from 356 to around 210 μmol/L and urine excretion protein reduced from 3.4 g/d to about 0.5 g/d after 6 months of the initiation of this regimen, respectively. These perfect treatment effects could maintain well during the whole follow-up period. No obvious complications were observed.

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European evidence-based recommendations for the diagnosis and treatment of childhood-onset lupus nephritis: the SHARE initiative

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-211898 ◽

2017 ◽

Vol 76 (12) ◽

pp. 1965-1973 ◽

Cited By ~ 31

Author(s):

Noortje Groot ◽

Nienke de Graeff ◽

Stephen D Marks ◽

Paul Brogan ◽

Tadej Avcin ◽

...

Keyword(s):

Lupus Nephritis ◽

Maintenance Treatment ◽

Low Dose ◽

Diagnosis And Treatment ◽

Nominal Group ◽

Induction Treatment ◽

Expert Committee ◽

Evidence Based ◽

Childhood Onset ◽

Dose Prednisone

Lupus nephritis (LN) occurs in 50%–60% of patients with childhood-onset systemic lupus erythematosus (cSLE), leading to significant morbidity. Timely recognition of renal involvement and appropriate treatment are essential to prevent renal damage. The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative aimed to generate diagnostic and management regimens for children and adolescents with rheumatic diseases including cSLE. Here, we provide evidence-based recommendations for diagnosis and treatment of childhood LN. Recommendations were developed using the European League Against Rheumatism standard operating procedures. A European-wide expert committee including paediatric nephrology representation formulated recommendations using a nominal group technique. Six recommendations regarding diagnosis and 20 recommendations covering treatment choices and goals were accepted, including each class of LN, described in the International Society of Nephrology/Renal Pathology Society 2003 classification system. Treatment goal should be complete renal response. Treatment of class I LN should mainly be guided by other symptoms. Class II LN should be treated initially with low-dose prednisone, only adding a disease-modifying antirheumatic drug after 3 months of persistent proteinuria or prednisone dependency. Induction treatment of class III/IV LN should be mycophenolate mofetil (MMF) or intravenous cyclophosphamide combined with corticosteroids; maintenance treatment should be MMF or azathioprine for at least 3 years. In pure class V LN, MMF with low-dose prednisone can be used as induction and MMF as maintenance treatment. The SHARE recommendations for diagnosis and treatment of LN have been generated to support uniform and high-quality care for all children with SLE.

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