Drug3rd line

Cyclophosphamide

Alkylating agent; potent immunosuppression, depletes B and T cells

Response rate
Effective for severe organ involvement
Onset
Weeks
Route
IV pulse or oral
Line
3rd
IgM effect
Reduces anti-C1q antibody production
Evidence level
amber

Evidence summary

Reserved for severe HUVS with major organ involvement (crescentic GN, severe vasculitis). Worm et al. demonstrated efficacy of cyclophosphamide-dexamethasone pulse therapy in 2 refractory patients. Often used as induction therapy before transitioning to mycophenolate or azathioprine for maintenance.

Approved indications

Conditions for which Cyclophosphamide has regulatory approval (not specific to rare diseases covered here):

Lupus NephritisANCA-Associated VasculitisVarious Malignancies

Drug identifiers

DrugBankDB00531
ATC CodeL01AA01