Stephen L. Scheeler, MD
To the Editors: In their study of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis and systemic vasculitis, Falk and associates (1) conclude that "therapy with either intravenous cyclophosphamide or oral cyclophosphamide is effective in patients with renal-limited disease as well as in those with glomerulonephritis and alveolar hemorrhage." In their experience, intravenous cyclophosphamide had proved to be a reliable and efficacious therapy.
These findings are at odds with those of Hoffman and co-workers (2), who did a study of pulse intravenous cyclophosphamide as therapy for Wegener granulomatosis. These investigators noted an initial high percentage of responders.
However, the long-term failure rate was
Scheeler SL. Anti-Neutrophil Cytoplasmic Autoantibody-Associated Glomerulonephritis. Ann Intern Med. ;114:430–431. doi: 10.7326/0003-4819-114-5-430
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Published: Ann Intern Med. 1991;114(5):430-431.
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