Prospective study of low-dose cyclosporine A in patients with refractory lupus nephritis

Hiroe Ogawa, Hideto Kameda, Hayato Nagasawa, Naoya Sekiguchi, Hirofumi Takei, Kensei Tsuzaka, Koichi Amano, Tsutomu Takeuchi

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33 Citations (Scopus)


We evaluated the efficacy and safety of low-dose cyclosporine A (CsA) in patients with refractory lupus nephritis. Nine patients with systemic lupus erythematosus who had lupus nephritis resistant to previous treatment with glucocorticoids and immunosuppressants other than CsA were enrolled in a prospective, open-label study. All patients initially received 2.5 mg/kg per day of CsA; the dosage was adjusted to reach a blood trough level of 80-150ng/ml. The urinary protein concentration decreased significantly 2 weeks after the initiation of treatment. After 30 weeks of CsA treatment, the mean urinary protein concentration was more than 50% lower than the baseline value, and urinary casts had decreased significantly. There were no significant changes in the levels of serum creatinine, serum anti-double-stranded DNA antibodies, or CH50 during any part of the study. The dose of glucocorticoids was significantly tapered by approximately 50%, without any disease flare. Hypertension developed in one patient, but was controlled with antihypertensive agents. Our results suggest that low-dose CsA therapy is an effective and less toxic alternative to conventional cyclophosphamide therapy for the management of refractory lupus nephritis.

Original languageEnglish
Pages (from-to)92-97
Number of pages6
JournalModern rheumatology
Issue number2
Publication statusPublished - 2007 Apr
Externally publishedYes


  • Cyclosporine A
  • Immunosuppressivedrugs
  • Lupusnephritis
  • Systemiclupus erythematosus

ASJC Scopus subject areas

  • Rheumatology


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