What steroid regimen do you typically use for induction therapy in patients with lupus nephritis?
LN initial treatment requires at least three choices: First, initial steroids as pulse methylprednisolone vs. high-dose oral prednisone (e.g., 1 mg/kg/day). Second, if selecting pulse steroids, follow with 1 mg/kg vs. 0.5 mg/kg. And third, double vs. triple immunosuppression from the outset.
LN treat...
To add to Dr. @H Michael Belmont 's excellent, comprehensive answer, for those not fully aware of the AURORA I trial (phase 3 voclosporin); it taught us that we can get away with MUCH less steroids than were previously used, which were done by custom rather than true medical evidence for dosing.
For...
By the way: I never use 1000 mg anymore; I use 500 mg as the maximum amount at one time.
Read the Cruces (Guillermo Ruiz-Irastorza's group) vs Bordeaux regimens (Ruiz-Irastorza et al., PMID 28564619).
Cruces = used more episodes of IV pulse steroids (taking advantage of the non-genomic effects) with l...
I try to use the steroid regimen that we used in the phase II and III studies of vocolsporin in LN. I like to start with around 1gm of methylprednisolone given over two days, maybe 1.5 grams over 3 days if a lot of inflammation on the biopsy, and then usuall will start oral prednisone at about 0.4-0...
I will typically induct with pulsed dose glucocorticoids (500-1000 mg IV) for 3 days, followed by a lower oral glucocorticoid regimen of 0.3-0.5 mg/kg/day, with a maximum dose of 40 mg/day. Practically, I try to get down to 10 mg within 8 weeks and then will taper by no faster than 2.5 mg every 2 we...