Dear All,

Greetings of the day!

Some interesting articles about RA and lupus are highlights of this issue. Aga AB and his colleagues have reported a 2-fold rise in remission rates and consistent improvement in other disease activity measures over a period of 10 years from 2000 to 2010. Importantly, this rise in remission rates was seen in both arms—MTX monotherapy and the more expensive combination with TNFi. In a way, this reflects the following outcomes of new treatment strategies over the last decade: (1) early diagnosis and treatment and (2) treat to target.

After achieving similar outcomes with MMF and cyclophosphamide in lupus nephritis induction in some ethnic groups, MMF has become the mainstay of induction therapy for lupus nephritis. Some initial studies have shown good results with MMF as maintenance therapy in the same condition, but cost has always been an issue with this drug, especially in the underdeveloped countries. Azathioprine has been used for many decades for the treatment of lupus nephritis and hence the question if it would be as efficacious as MMF as maintenance therapy. Addressing this issue in their trial MAINTAIN, Tamirou and his team did not find MMF to be superior to azathioprine.

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Regards,

Banwari Sharma
Editor, IRA e-Newsletter