PDF | On Jan 1, , E.M. Ginzler and others published Aspreva Lupus Management Study (ALMS): Maintenance Results. [abstract]. *Members of the Aspreva Lupus Manage- ment Study (ALMS) Group are listed in the Supplementary Appendix, available at The study group underwent repeat randomization in a ratio. A total of patients were randomly assigned to maintenance treatment ( to a renal response to treatment and in preventing relapse in patients with lupus (Funded by Vifor Pharma [formerly Aspreva]; ALMS number, NCT).

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Sequential therapies for proliferative lupus nephritis. However, it has been suggested by the authors and others that a longer induction period may better distinguish the managemejt treatment arms.

Impact of the ALMS and MAINTAIN trials on the management of lupus nephritis.

Prospective registry-based observational cohort study of the long-term risk of malignancies in renal transplant patients treated with mycophenolate mofetil.

There were 24 withdrawals At the end of the week induction period, renal responses were lupu in Appel GB, et al. Moreover, although the subgroups are prespecified, the study is not specifically powered to detect differences and the somewhat increased death rate and difference in adverse aslreva profile compared to other studies is not explained.

Data from the ALMS study have been published in abstract form at the following congresses: Most patients who died had severe renal disease at baseline.


Long-term followup of a cohort of patients participating in randomized controlled studies.

Mycophenolate Mofetil versus Cyclophosphamide for Induction Treatment of Lupus Nephritis

In the MMF group, 35 Retrieved from ” http: Most patients excluded did not meet the study criteria sfudy baseline disease. Pulse intravenous corticosteroids were prohibited within 2 wk before first randomization and throughout the study. Exposure The median dosage was calculated for patients in the MMF group as 2.

There were more deaths in the MMF group, contrasting with previous trials.

Ann Rheum Dis In the initial, prospectively planned, primary efficacy analysis, interactions between treatment and these covariates were added and assessed at the 0. Focal proliferative class III and diffuse proliferative class IV lupus nephritis are mediated by immune and inflammatory mechanisms responsive to immunosuppression and antiinflammatory therapy, and preferred therapy has generally been with a combination of prednisone plus cyclophosphamide based upon a landmark study from the NIH.

In some patients, this led to continued aggressive treatment of lupus with MMF and high-dosage corticosteroids, which we speculate may have contributed to the overwhelming infection in patients whose immune status was unstable at study entry.

Impact of the ALMS and MAINTAIN trials on the management of lupus nephritis.

Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. The relationship between cancer and medication exposures in systemic lupus erythematosus: Risk for sustained amenorrhea in patients with systemic lupus erythematosus receiving intermittent pulse cyclophosphamide therapy. Renal flares are common in patients with severe proliferative lupus nephritis treated with pulse immunosuppressive therapy: The h urine collections were obtained at baseline and every 4 wk thereafter managmeent completion of the wk induction phase.


Long-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse sgudy lupus nephritis. This article has been cited by other articles in PMC.

Mycophenolate mofetil for induction therapy of lupus nephritis: A meta-analysis of randomized controlled trials. A systematic review and meta-analysis. Efficacy The primary efficacy end point was achieved in Publication date available at www. There was lupys progression on the Systemic Lupus International Collaborating Clinics damage index in either patient group.

Open in a separate window. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.

There were no statistically significant differences between the scores of each treatment group on any of the secondary efficacy end points Table 3. This page was last modified on 4 Februaryat There were no crossovers between treatments during the study. Articles from Journal of the American Society of Nephrology: Supplementary Material [Supplemental Data] Click here to view. The primary efficacy end point was achieved in Clinically qspreva renal involvement occurs asppreva approximately half of patients with lupus, and renal histology in patients with lupus nephritis predicts responsiveness to therapy.