Comparison study of leflunomide and cyclophosphamide on refractory nephrotic syndrome

Objective To compare the therapeutic effect,adverse effects and safety of leflunomide(LEF) and cyclophosphamide(CTX)intravenous pulse therapy on refractory nephrotic syndrome(RNS).Methods One hundred and twenty patients with refractory nephrotic syndrome were randomly divided into two groups.Based on hormone application,sixty cases in LEF group were given LEF taken orally and 60 cases in CTX group were given CTX intravenous drip discontinuously.They were followed up for twenty-four months.clinical datas were observed at the 2nd,4th,6th,8th,12th,16th,20th,24th,28th weeks.The related indexes and possible concomitant adverse effects were detected.Results After the follow up phase,the total effective rate in LEF group was 81.66%and that in CTX group was 78.33%.The total effective rate of the two group was not significant difference,24 hours urine protein quantitity in LEF group was obviously decreased(P0.05),serum albumin was obviousely increased(P0.05),and there was significantly difference(P0.05).No case tropped out because of serious adverse effects.The total rate of adverse effects in LEF group was 15%,and the total rate of adverse effects in CTX group was 26.7%.Conclusion LEF combined with glucocorticoid on RNS has better curative effect and the tolerance is better,but the long-term curative effect needs further observing.