Refractory mixed proliferative and membranous lupus nephritis treated with the topoisomerase I inhibitor irinotecan as add-on therapy
Refractory mixed proliferative and membranous lupus nephritis treated with the topoisomerase I inhibitor irinotecan as add-on therapy
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使用拓扑异构酶 I 抑制剂伊立替康作为附加疗法治疗难治性混合性增殖性和膜性狼疮肾炎
DOI：
10.1080/03009742.2021.1980979
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发表时间：
2022
影响因子：
2.1
通讯作者：
Frese S
中科院分区：
文献类型：
--
作者：
Biesen R;Frese-Schaper M;Enghard P;Cheng Q;Hiepe F;Frese S
目的评价拓扑异构酶I抑制剂伊立替康治疗难治性狼疮性肾炎的疗效和安全性。方法1例难治性狼疮性肾炎患者在接受霉酚酸、泼尼松龙和羟氯喹治疗的基础上加用小剂量伊立替康治疗。伊立替康以50 mg/m2的剂量每4周给药一次，持续4个周期，随后以100 mg/m2的剂量再持续8个周期。肾功能和抗双链DNA抗体以及血细胞计数的副作用进行了评估，在治疗过程中与irinotecan.ResultsBefore开始治疗与irinotecan，尿蛋白/肌酐比为1298毫克/克确定。使用50 mg/m2伊立替康治疗4个周期后，该值降至613 mg/g，使用更高剂量的伊立替康时，该值进一步降至198 mg/g。肾功能保持稳定，伊立替康治疗开始时肌酐水平为1.66 mg/dL，治疗结束时为1.76 mg/dL。重要的是，没有副作用，如腹泻或中性粒细胞减少症，在整个疗程中观察到的treatment.ConclusionAdministration低剂量伊立替康作为添加药物治疗难治性狼疮肾炎被证明是安全的。伊立替康是否能改善肾功能和难治性狼疮性肾炎患者的预后还需要临床试验来确定。
ObjectiveTo evaluate the safety and effects of irinotecan, an inhibitor of topoisomerase I, on refractory lupus nephritis.MethodA patient with refractory lupus nephritis under medication with mycophenolic acid, prednisolone, and hydroxychloroquine was treated with add-on low-dose irinotecan. Irinotecan was applied every fourth week at a dose of 50 mg/m2for four cycles followed by 100 mg/m2for another eight cycles. Renal function and anti-double-stranded DNA antibodies as well as blood count for evaluation of side effects were assessed during the treatment with irinotecan.ResultsBefore starting the treatment with irinotecan, a urine protein/creatinine ratio of 1298 mg/g was determined. This declined to 613 mg/g after four cycles with 50 mg/m2irinotecan and was further reduced to 198 mg/g when using the higher dose of irinotecan. Kidney function remained stable, with creatinine levels of 1.66 mg/dL at the beginning and 1.76 mg/dL at the end of treatment with irinotecan. Importantly, no side effects, such as diarrhoea or neutropenia, were observed during the entire course of treatment.ConclusionAdministration of low-dose irinotecan as add-on medication for the treatment of refractory lupus nephritis was shown to be safe. Clinical trials are needed to determine whether irinotecan can improve kidney function and the outcome of patients with refractory lupus nephritis.
用拓扑异构酶 I 抑制剂伊立替康治疗后，新西兰黑×新西兰白小鼠的狼疮性肾炎得到逆转并延长了生存期
影响因子：
4.4
作者：
M. Frese‐Schaper;J. Zbaeren;M. Gugger;M. Monestier;S. Frese
通讯作者：
S. Frese
影响因子：
4.9
作者：
Keil A;Hall SR;Körner M;Herrmann M;Schmid RA;Frese S
通讯作者：
Frese S