Cyclosporine A or Intravenous Cyclophosphamide for Lupus Nephritis: The Cyclofa-Lune Study

Inclusion Criteria: * the diagnosis of systemic lupus erythematosus (by meeting 4 criteria of the American College of Rheumatology) * renal biopsy documenting lupus nephritis according to the classification of the World Health Organization (WHO) or the updated International Society of Nephrology/Renal Pathology Society (ISN/RPS) as proliferative glomerulonephritis class III (focal) or IV (diffuse) * clinical activity as defined by presence of at least two of the following: * abnormal proteinuria (more than 500mg of protein in in a 24-hour urine specimen) * abnormal microscopic hematuria, or * C3 hypocomplementemia (the latter two were defined according to the norms in the laboratories of the participating centers) Exclusion Criteria: * treatment with cyclophosphamide or cyclosporine A ever before * treatment with other immunosuppressive drugs (such as azathioprine or mycophenolate mofetil) or high dose glucocorticoids (≥ 80mg of prednisone or methylprednisolone) within the last 3 months * persistent elevation of serum creatinine (≥140 μmol/l) * pregnancy or lactation * bone marrow insufficiency with cytopenias not attributable to SLE, and 8severe coexisting conditions, such as infection, liver disease, active peptic ulcer etc.