OBJECTIVE: To study prospectively the effect of treatment with cyclophosphamide pulses (CYC) or azathioprine with methylprednisolone (AZA), both for 24-month periods, on health-related quality of life (HRQOL) in patients with proliferative lupus nephritis (LN) in a randomized controlled trial. We expected better HRQOL during AZA treatment. METHODS:HRQOL and disease activity were measured at start and after 12 and 24 months. Generic questionnaires [patient's visual analog scale (VAS), Medical Outcomes StudyShort Form-36 Health Survey (SF-36), Profile of Mood States] and a disease-specific measure [Systemic Lupus Erythematosus (SLE) Symptom Checklist] were used. Treatment burden was assessed at 24 months. Disease activity was measured with the SLE Disease Activity Index (SLEDAI) and physician's VAS. RESULTS: Complete questionnaire data were available from 47 of the 87 patients included in the trial. These patients were representative of the whole group, except that completers were more often Caucasian. HRQOL scores improved significantly during treatment, particularly during the first year, on both generic and disease-specific outcomes. No statistically significant differences were found in HRQOL between the CYC and AZA groups, except for the SF-36 mental component summary scale, which showed more favorable scores in the AZA group. The mean reported treatment burden at 24 months was significantly higher in the CYC group. HRQOL scores did not correlate with the SLEDAI and physician's VAS. The disease activity measures correlated positively with each other. CONCLUSION: Treatment of patients with proliferative LN with immunosuppressive drugs andcorticosteroids improves HRQOL, particularly in the first year. Due to the small groups studied, the absence of differences between AZA and CYC for most HRQOL scales should be interpreted cautiously: our data suggest that there may be no significant differences. Differences were a higher perceived treatment burden and worse mental HRQOL in the CYC group.
RCT Entities:
OBJECTIVE: To study prospectively the effect of treatment with cyclophosphamide pulses (CYC) or azathioprine with methylprednisolone (AZA), both for 24-month periods, on health-related quality of life (HRQOL) in patients with proliferative lupus nephritis (LN) in a randomized controlled trial. We expected better HRQOL during AZA treatment. METHODS: HRQOL and disease activity were measured at start and after 12 and 24 months. Generic questionnaires [patient's visual analog scale (VAS), Medical Outcomes Study Short Form-36 Health Survey (SF-36), Profile of Mood States] and a disease-specific measure [Systemic Lupus Erythematosus (SLE) Symptom Checklist] were used. Treatment burden was assessed at 24 months. Disease activity was measured with the SLE Disease Activity Index (SLEDAI) and physician's VAS. RESULTS: Complete questionnaire data were available from 47 of the 87 patients included in the trial. These patients were representative of the whole group, except that completers were more often Caucasian. HRQOL scores improved significantly during treatment, particularly during the first year, on both generic and disease-specific outcomes. No statistically significant differences were found in HRQOL between the CYC and AZA groups, except for the SF-36 mental component summary scale, which showed more favorable scores in the AZA group. The mean reported treatment burden at 24 months was significantly higher in the CYC group. HRQOL scores did not correlate with the SLEDAI and physician's VAS. The disease activity measures correlated positively with each other. CONCLUSION: Treatment of patients with proliferative LN with immunosuppressive drugs and corticosteroids improves HRQOL, particularly in the first year. Due to the small groups studied, the absence of differences between AZA and CYC for most HRQOL scales should be interpreted cautiously: our data suggest that there may be no significant differences. Differences were a higher perceived treatment burden and worse mental HRQOL in the CYC group.
Authors: Simon A Carter; Talia Gutman; Charlotte Logeman; Dan Cattran; Liz Lightstone; Arvind Bagga; Sean J Barbour; Jonathan Barratt; John Boletis; Dawn Caster; Rosanna Coppo; Fernando C Fervenza; Jürgen Floege; Michelle Hladunewich; Jonathan J Hogan; A Richard Kitching; Richard A Lafayette; Ana Malvar; Jai Radhakrishnan; Brad H Rovin; Nicole Scholes-Robertson; Hérnan Trimarchi; Hong Zhang; Karolis Azukaitis; Yeoungjee Cho; Andrea K Viecelli; Louese Dunn; David Harris; David W Johnson; Peter G Kerr; Paul Laboi; Jessica Ryan; Jenny I Shen; Lorena Ruiz; Angela Yee-Moon Wang; Achilles Hoi Kan Lee; Samuel Fung; Matthew Ka-Hang Tong; Armando Teixeira-Pinto; Martin Wilkie; Stephen I Alexander; Jonathan C Craig; Allison Tong Journal: Clin J Am Soc Nephrol Date: 2020-04-30 Impact factor: 8.237
Authors: Simon A Carter; Liz Lightstone; Dan Cattran; Allison Tong; Arvind Bagga; Sean J Barbour; Jonathan Barratt; John Boletis; Dawn J Caster; Rosanna Coppo; Fernando C Fervenza; Jürgen Floege; Michelle A Hladunewich; Jonathan J Hogan; A Richard Kitching; Richard A Lafayette; Ana Malvar; Jai Radhakrishnan; Brad H Rovin; Nicole Scholes-Robertson; Hernán Trimarchi; Hong Zhang; Samaya Anumudu; Yeoungjee Cho; Talia Gutman; Emma O'Lone; Andrea K Viecelli; Eric Au; Karolis Azukaitis; Amanda Baumgart; Amelie Bernier-Jean; Louese Dunn; Martin Howell; Angela Ju; Charlotte Logeman; Melissa Nataatmadja; Benedicte Sautenet; Ankit Sharma; Jonathan C Craig Journal: Clin J Am Soc Nephrol Date: 2021-12-30 Impact factor: 8.237
Authors: David J Tunnicliffe; Suetonia C Palmer; Lorna Henderson; Philip Masson; Jonathan C Craig; Allison Tong; Davinder Singh-Grewal; Robert S Flanc; Matthew A Roberts; Angela C Webster; Giovanni Fm Strippoli Journal: Cochrane Database Syst Rev Date: 2018-06-29
Authors: John G Hanly; Aidan G O'Keeffe; Li Su; Murray B Urowitz; Juanita Romero-Diaz; Caroline Gordon; Sang-Cheol Bae; Sasha Bernatsky; Ann E Clarke; Daniel J Wallace; Joan T Merrill; David A Isenberg; Anisur Rahman; Ellen M Ginzler; Paul Fortin; Dafna D Gladman; Jorge Sanchez-Guerrero; Michelle Petri; Ian N Bruce; Mary Anne Dooley; Rosalind Ramsey-Goldman; Cynthia Aranow; Graciela S Alarcón; Barri J Fessler; Kristjan Steinsson; Ola Nived; Gunnar K Sturfelt; Susan Manzi; Munther A Khamashta; Ronald F van Vollenhoven; Asad A Zoma; Manuel Ramos-Casals; Guillermo Ruiz-Irastorza; S Sam Lim; Thomas Stoll; Murat Inanc; Kenneth C Kalunian; Diane L Kamen; Peter Maddison; Christine A Peschken; Soren Jacobsen; Anca Askanase; Chris Theriault; Kara Thompson; Vernon Farewell Journal: Rheumatology (Oxford) Date: 2015-09-05 Impact factor: 7.580