G.A. SHOVE, M.D.
To the editor: The article by Carette and associates (1) on the treatment of lupus nephritis leaves several questions in my mind. The authors' conclusion is that single-drug, oral immunosuppressive treatment combined with prednisone is the most beneficial in patients with lupus nephritis with intermediate chronic change shown by renal biopsy. Although this conclusion is attractive, a review of the study's progression since 1969 raises doubts.
Were any of the patients who participated in the cyclophosphamide or placebo study (2) subsequently entered in the three-arm study? Because the three-arm study excluded patients with a creatine clearance greater than 4 mg/dL,
SHOVE G. Lupus Nephritis. Ann Intern Med. ;99:732–733. doi: 10.7326/0003-4819-99-5-732_2
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Published: Ann Intern Med. 1983;99(5):732-733.
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