Korean J Nephrol.  2007 Mar;26(2):160-166.

Mycophenolate Mofetil or Intravenous Cyclophosphamide for the Initial Induction Therapy of Lupus Nephritis; Clinical Observations

Affiliations
  • 1Department of Internal Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea. yoongookim@samsung.com
  • 2Department of Pathology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE: The combination of intravenous cyclophosphamide (CYC) and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Mycophenolate mofetil (MMF) Is a new immunosuppressive agent that selectively inhibits activated lymphocytes. This study reports on the clinical experiences at our clinic with MMF and intravenous CYC for the initial induction treatment in patients with lupus nephritis.
METHODS
50 patients with lupus nephritis received induction therapy consisting of MMF and prednisolone (n=22) or intravenous CYC and prednisolone (n=28), and followed up for six months. Complete remission was defined as a value for urinary protein: urinary creatinine ratio (U(p/Cr)) that was less than 0.3, with normal urinary sediment, a normal serum albumin concentration and values for serum creatinine that were no more than 15 percent above the base-line values. Partial remission was defined as a value for U(p/Cr) that was between 0.3 and 2.9, with a serum albumin concentration of at least 3.0 g/dL.
RESULTS
22 patients treated with MMF and 28 patients with intravenous CYC resulted in complete remission (31.8% vs 39.3%), partial remission (45.5% vs 39.3%) and treatment failure (22.7% vs 21.4 %). Fewer severe infections occurred among patients treated with MMF and prednisolone.
CONCLUSION
As for the induction therapy of lupus nephritis, the combination of MMF and prednisolone may be an effective regimen. However, further randomized, prospective studies are needed to prove the effectiveness of MMF therapy in lupus nephritis.

Keyword

Lupus nephritis; Mycophenolate mofetil; Cyclophosphamide

MeSH Terms

Creatinine
Cyclophosphamide*
Humans
Lupus Nephritis*
Lymphocytes
Prednisolone
Serum Albumin
Treatment Failure
Creatinine
Cyclophosphamide
Prednisolone
Serum Albumin
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