Leflunomide Vs. Cyclophosphamide In The Treatment Of Lupus Nephritis: A Mata-analysis

OBJECTIVE:To assess the efficacy and safety of leflunomide (LEF) and cyclophospha- mide (CYC) in the treatment of lupus nephritis.METHODS: We searched Pubmed, EMBASE and the Cochrane Collaboration Database for RCTs that compared LEF with CYC in patients with lupus nephritis. Efficacy measures in the meta analysis included 24-hour urine protein, serum albumin,serum creatinine level, complement C3, and SLEDAI score. Adverse reactions were also compared. The software RevMan 4.2.2 was used to review management and data analysis.The results were expressed as RR and 95% confidence intervals(CI) for categorical outcomes and WMD for continuous outcomes.RESULTS: Six eligible RCTs involving 270 patients were included. LEF offered similar efficacy as CYC. Significantly fewer patients receiving LEF developed GI symptoms (P<0.05). The risk of infection, alopecia, leukopenia and elevated liver enzymes was comparable in the two groups.CONCLUSIONS: LEF is equally effective in the treatment of lupus nephritis, but has fewer side adverse events.