Cyclophosphamide in Progressive Membranous Glomerulopathy: Pro and Con
Authors: Harold I. Feldman, Michael P. Madaio
Journal: Annals of Internal Medicine (1992)

Letters15 October 1992Cyclophosphamide in Progressive Membranous Glomerulopathy: Pro and ConHarold I. Feldman, MD, MS, Michael P. Madaio, MDHarold I. Feldman, MD, MSSearch for more papers by this author, Michael P. Madaio, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-8-696 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Although the report by Falk and associates (1) provides new data regarding the prognosis and therapy of membranous glomerulopathy, several aspects of this study limit its general applicability to the treatment of patients with progressive forms of this disease.A convincingly negative clinical trial should have a power of 80% or greater. Table 1 is based on the comparison of two survival distributions (2) using data provided in the paper. For this purpose the median renal survival in the study's steroid only treated group was taken as either 30 or 36 months from randomization. This assumption is...References1. FalkHoganMullerJennette RSKJ. Treatment of progressive membranous glomerulopathy: A randomized trial comparing cyclophosphamide and corticosteroids with corticosteroids alone. Ann Intern Med. 1992;116:438-45. LinkGoogle Scholar2. SchoenfeldRichter DJ. Nomograms for calculating the number of patients needed for a clinical trial with survival as an endpoint. Biometrics. 1982;38:163-70. CrossrefMedlineGoogle Scholar3. PonticelliZucchelliImbasciatiCagnoliPozzi CPELC. Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy. N Engl J Med. 1984;310:946-50. CrossrefMedlineGoogle Scholar4. . A controlled study of short-term prednisone treatment in adjuts with membranous nephropathy. N Engl J Med. 1979;301:1301-6. CrossrefMedlineGoogle Scholar5. WalserDrewLaFrance MHN. Reciprocal creatinine slopes often give erroneous estimates of progression of chronic renal failure. Kidney Int. 1989;36:S81-5. Google Scholar1. FalkHoganMullerJennette RSKC. Treatment of progressive membranous nephropathy: a randomized trail comparing cyclophosphamide and corticosteroids with corticosteroids alone. Ann Intern Med. 1992;116:438-45. LinkGoogle Scholar2. JindalWestBearGoldstein KMRM. Long term benefits of therapy with cyclophosphamide and prednisone in patients with membranous glomerulonephritis and impaired renal function. Am J Kidney Dis. 1992;19:61-7. CrossrefMedlineGoogle Scholar3. BrunsAdlerFraleySegel FSDJ. Sustained remission of membranous glomerulonephritis after cyclophosphamide and prednisone. Ann Intern Med. 1991;114:725-30. LinkGoogle Scholar4. MathiesonTurnerMaidmentEvansRees PACDA. Prednisolone and chlorambucil treatment in idiopathic membranous nephropathy with deteriorating renal function. Lancet. 1988;2:869-72. CrossrefMedlineGoogle Scholar5. CameronHealyAdu JMD. The medical research council trial of short term, high-dose alternate day prednisone in idiopathic membranous nephropathy with a nephrotic syndrome in adults. Q J Med. 1990;74:133-45. CrossrefMedlineGoogle Scholar1. FalkHoganMullerJennette RSKJ. Treatment of progressive membranous glomerulopathy: a randomized trial comparing cyclophosphamide and corticosteroids with corticosteroids alone. Ann Intern Med. 1992;116:438-45. LinkGoogle Scholar2. HoffmanKerrLeavittHallahanLebovicsTravis GGRCRW. Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med. 1992;116:488-98. LinkGoogle Scholar3. WalserDrewLaFrance MHN. Reciprocal creatinine slopes often give erroneous estimates of progression of chronic renal failure. Kidney Int. 1989;35(S27):S81-85. Google Scholar4. . Assessing the progression of renal disease in clinical studies: effects of duration of follow-up and regression to the mean. J Am Soc Nephrol. 1991;1:187-94. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania School of Medicine Philadelphia, PA 19104 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMembranous glomerulopathy 15 October 1992Volume 117, Issue 8Page: 696-697KeywordsClinical trialsCyclophosphamidePatientsStatistical distributions Issue Published: 15 October 1992 PDF downloadLoading ...