How do you determine duration of therapy for patients who have responded well to voclosporin therapy?
How do you monitor response and what do you consider a satisfactory response? Do you aim for a certain threshold of proteinuria?
Answer from: at Academic Institution
Determining the duration of therapy for patients who have responded well to voclosporin therapy in lupus nephritis involves several considerations, including patient-specific factors, disease activity, and risk of relapse. Here is a suggested approach:The duration of therapy is determined by the ren...
The first order of business is to taper steroids, and hopefully discontinue them. If the patient is doing well, I taper their background immunosuppressive, which is usually MMF. The question, thereafter, is whether to stop the background therapy or taper the second drug. In the case of the combinati...
I assess response per the EULAR guidelines (which were extrapolated from trials like the ALMS trial):
At 3 months, success is at least a 25% reduction in proteinuria and no worsening of renal function.
At 6 months, success is at least a 50% reduction in proteinuria and no worsening of renal functi...