From: Interventions for renal vasculitis in adults. A systematic review
Study ID | Treatment | Control | Study outcomes |
---|---|---|---|
Adu 1997 | CPA 15 mg/kg and MP were given IV at 0, 2 and 4 weeks. The same dose was then given as oral pulses over a 3-day period. The interval between pulses was gradually increased. | initial treatment - 0.85 mg/kg prednisolone then tapering according to a predefined schedule for 72 weeks. CPA 2 mg/kg/d given until a clinical decision that remission had been achieved at which point CPA was stopped and AZA commenced at 1.5 mg/kg/d | 1. Complete and partial remission 2. Relapse 3. Adverse events 4. Treatment failure 5. Chronic dialysis |
De Groot 2009a | 3 iv pulses of CPA 15 mg/kg 2 weeks apart followed by 3 weekly pulses (15 mg/kg iv or 5 mg/kg orally for 3 days) until remission then for another 3 months. Mac dose 1.2 G. Reductions for age > 60 yrs and serum creatinine > 300 uM and for previous low leukocyte nadir. | oral CPA 2 mg/kg/d to remission then 1.5 mg/kg for further 3 months. Max oral dose 200 mg. Reductions for age > 60 yrs and leukopenia Both groups received Azathioprine 2 mg/kg/d orally after induction therapy until month 18. Prednisolone 1 mg/kg orally tapered to 12.5 mg/d at the end of month3 and 5 mg at end of study | 1. Time to Remission 2. Change in renal function 3. Adverse events 4. Cumulative dose of CPA |
Guillevin 1997 | Initial regimen: IV MP 15 mg/kg/d for 3 days. IV CPA 0.7 g/m2 day 4. Oral prednisolone 1 mg/kg/d from day 4. IV pulse CPA: mean dose 0.7 g/m2 adjusted for count and renal function, administered every 3 weeks until complete remission and 1 year thereafter. Then every 4 weeks for 4 months, every 5 weeks for 4 months and every 6 weeks until discontinuation after 2 years if treatment. Adjusted up or down based on neutrophil count. | Initial regimen: IV MP 15 mg/kg/d for 3 days. IV CPA 0.7 g/m2day 4. Oral prednisolone 1 mg/kg/d from day 4. Oral CPA: 2 mg/kg/d on day 10 after initial CPA pulse, after neutrophil nadir had been reached. 1 year after complete remission, oral CPA was tapered by 25% every 4 months until discontinuation. Dose adjusted up or down based on neutrophil count. | 1. Treatment failure 2. Complete remission 3. Partial remission 4. Relapse 5. Death 6. Side effects |
Haubitz 1998 | Steroid regime: Days 1-3, 0.5 g IV MP. Day 4 1 mg/kg/d oral prednisolone. Tapered from day 15. IV Pulse CPA - 0.75 g/m2every 4th week. If CrCl < 30 ml/min, initial dosage was 0.5 g/m2 and increased to 0.75 g/m2provided leukocyte counts remained > 3000/ml | Steroid regime: Days 1-3, 0.5 g IV MP. Day 4 1 mg/kg/d oral prednisolone. Tapered from day 15. Oral daily CPA - 2 mg/kg/d. If CrCl < 30 ml/min, initial dosage started at 1.5 mg/kg/d and increase to 2 mg/kg/d after 2 weeks provided leukocyte counts were > 3000/ml CPA dose reduced in steps of 0.5 mg/kg, unless leukocyte count was < 2500/ml then dose reduced by 50%, and if less than 1500/ml drug was withheld until increased to 2500/ml | 1. Complete remission 2. Partial remission 3. Relapse 4. Serious infection |