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August 13, 1982

Quantifying SLE renal biopsy results aids clinician

JAMA. 1982;248(6):623. doi:10.1001/jama.1982.03330060005003

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A chronicity index based on renal biopsy appears to be a "very strong" predictor of outcome for patients with nephritis secondary to systemic lupus erythematosus (SLE), according to Simon Carette, MD, a fellow at the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases (NIADDKD), Bethesda, Md.

Speaking in Washington, DC, at the Pan-American Congress of Rheumatology for himself and NIADDKD co-workers, Carette described a long-term study showing that only patients with low to moderate chronicity levels did well when treated with cytotoxic drugs.

Fifty-three patients were entered in the seven-year study. Requirements for admission included (1) a diagnosis of SLE by American Rheumatism Association criteria and (2) kidney disease unaccounted for by other pathological processes and confirmed by laboratory tests and biopsy specimens.

The patients were randomized to receive one of three programs: azathioprine, up to 4 mg/kg/day, plus prednisone, up to 0.5 mg/kg/day; cyclophosphamide, up to 4