Cyclophosphamide Versus Leflunomide Combined with Prednisone Respectively in Treatment of Chronic Progressive IgA Nephropathy

Objective:To compare the efficacy and safety of cyclophosphamide( CTX) or leflunomide( LEF) combined with prednisone respectively in treatment of chronic progressive IgA nephropathy( IgAN).Methods:A retrospective analysis about 57 IgAN patients from June 2009 to July 2012,which were Lee's grade Ⅱ or above,and treated with CTX( 25cases) or LEF( 32cases) combined to prednisone respectively,clinical datas were collected before treatment and during monthly follow-up.Results:The overall 24h urine protein remission rate of the two groups was 87.7%,The partial remission rate of CTX group and LEF group were7 cases( 28.0%) and 11 cases( 34.4%) respectively( P = 0.607),complete remission rate of that were 14 cases( 56.0%) and 18( 56.2%) respectively( P =0.985).CTX group and LEF group partial remission time was( 2.95 ±1.70) month and( 3.27 ± 3.01) month respectively,the difference was statistically significant( P = 0.048),the complete remission time was( 5.45 ± 3.31) month and( 6.69 ± 5.82) month( P = 0.052).During follow-up,there was 12.0% incidence of side effects in CTX group and 6.25% in LEF group.Conclusion:The treatment with CTX or LEF combined prednisone in chronic progressive IgAN has the same effect,Partial remission time in CTX group is faster than that in LEF group,the long-term efficacy and safety remains to be clarified.