Treatment‐free remission in severe systemic lupus erythematosus following synchronization of plasmapheresis with subsequent pulse cyclophosphamide

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Abstract
Objective. To investigate the effect of an intensified treatment protocol synchronizing plasmapheresis with subsequent pulse cyclophosphamide for severe systemic lupus erythematosus (SLE). Methods. A protocol of plasmapheresis (3 x 60 ml/kg) and subsequent high‐dose pulse cyclophosphamide (36 mg/kg) followed by 6 months of peroral immunosuppression was used to treat 14 patients with severe SLE. Results. Rapid improvement was achieved in all patients. Immunosuppressants, including corticosteroids, were withdrawn at month 6 in 12 patients. Eight patients continued without treatment for a mean observation period of 5.6 years (46–91 months). Conclusion. The results demonstrate that treatment‐free clinical remission can be achieved in some patients with severe SLE.

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