Immunosuppressive Treatment for Proliferative Lupus Nephritis

The review of 74 studies with 5,175 participants on immunosuppressive treatments for proliferative lupus nephritis indicated that mycophenolate mofetil (MMF) might have been more effective than intravenous cyclophosphamide (CPA) in achieving complete remission and maintaining kidney function, with a better safety profile, particularly in reducing alopecia risk, though it increased the risk of diarrhea. MMF was also likely more effective than azathioprine for maintenance therapy in preventing renal relapse. The combination of MMF and tacrolimus showed promise for better renal remission, but the evidence was of low certainty. Overall, the review highlighted the need for more comprehensive studies to evaluate the efficacy and safety of these treatments, as the evidence was insufficient to establish their superiority or equivalence to the standard treatment.