New lupus treatment found to improve on chemotherapy

ALBANY, N.Y. -- Doctors are reporting the first advance in three decades in treating kidney complications from lupus, a life-threatening disease that primarily affects young women.

A small study found that an immune-suppression drug worked better than the standard chemotherapy, which can cause infertility and other problems.

For almost 25 percent of patients who took the newer drug, CellCept, their kidney problems went into complete remission after six months, compared with 6 percent of those who received the older treatment, cyclophosphamide. The CellCept patients also reported fewer side effects.

''This holds great promise for a better quality of life for people with lupus," said Sandra Raymond, president of the Lupus Foundation of America.

The study was led by Dr. Ellen Ginzler of the State University of New York's Downstate Medical Center in New York and is being published today in the New England Journal of Medicine.

Partial results were presented in 2003 at a scientific conference in Orlando, Fla.

Lupus is a disabling and sometimes fatal disease that mostly strikes women of childbearing age. About 1.5 million Americans have the disorder, in which the body's immune system attacks its organs and tissue. No one knows why it happens. One third of all lupus patients suffer from inflammation of the kidney, which lead to kidney failure.

For 30 years, chemotherapy has been the standard treatment for the kidney complications. But the side effects can include hair loss, nausea, and infertility, problems that can lead patients to skip their chemotherapy.

CellCept, made by Hoffmann-La Roche Inc., is approved by the Food and Drug Administration to prevent organ rejection in transplant patients. But some doctors prescribe it to lupus patients who cannot tolerate chemotherapy.

In the study, 140 people received either daily oral doses of CellCept or monthly intravenous doses of cyclophosphamide.

After six months, 23 percent of those who took CellCept had complete remission. An additional 30 percent in the CellCept group had partial remission, compared with 25 percent of those in the chemotherapy group.

The study was supported by grants from the FDA and Roche Laboratories.

In an accompanying editorial, Dr. W. Joseph McCune of the University of Michigan Medical Center wrote that CellCept will not become the standard of care until a , more definitive study is done.