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International Journal of Clinical Rheumatology, vol.5, no.6, pp.669-676, 2010 (Scopus)
The clinical features of Henoch-Schönlein purpura (HSP) are now well recognized; however, there remains uncertainty and a lack of consensus regarding treatment. Considerable concern has been expressed regarding the importance of identifying an improved, well-studied therapeutic protocol for use in the treatment of HSP. This article will focus on published studies, specifically randomized controlled trials, and aims to provide an evidence-based approach to the evaluation of therapy in children with HSP. We do have evidence that steroids do not protect against the development of kidney disease in patients with HSP. However, there is a clear lack of robust clinical trials for the treatment of moderate and severe HSP nephritis. At the present time, treatment of HSP nephritis is not guided by evidence from properly designed randomized controlled trials. We also lack consensus for the definition of outcome measures. Adequately powered, well-designed, multicenter, randomized controlled trials with follow-up periods of at least 5 years are particularly needed in children with HSP nephritis. © 2010 Future Medicine Ltd.