Mycophenolate Mofetil Therapy in Severe Membranous Nephropathy and Diffuse Proliferative Lupus Nephritis: Clinical Observation.
- Author:
Eun Hee JANG
1
;
Yeon Sil DO
;
So Yeon CHOI
;
Beom KIM
;
Jung Ah KIM
;
Min Ok KIM
;
Hyun Jin KIM
;
Ho Myoung YEO
;
Jung Eun LEE
;
Woo Sung HUH
;
Dae Joong KIM
;
Yoon Goo KIM
;
Ha Young OH
Author Information
1. Division of Nephrology, Department of Medicine, College of Medicine, Sungkyunkwan University, Seoul, Korea. yoongoo.kim@samsung.com
- Publication Type:Controlled Clinical Trial ; Original Article ; Clinical Trial
- Keywords:
Mycophenolate mofetil (MMF);
Cyclosphophamide;
Lupus nephritis;
Membranous nephropathy
- MeSH:
Biopsy;
Creatinine;
Cyclophosphamide;
Glomerulonephritis, Membranous*;
Humans;
Lupus Nephritis*;
Proteinuria;
Treatment Outcome
- From:Korean Journal of Nephrology
2005;24(5):763-771
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Although cyclophosphamide (CYC) is effective for the treatment of diffuse proliferative lupus nephritis (DPLN) and severe membranous nephropathy (MN), it has serious adverse effects. Therefore, we evaluated our clinical observations with mycophenolate mofetil (MMF) for empirical treatment of DPLN and severe MN. METHODS: Seventeen patients with biopsy proven severe MN (n=8) and DPLN (n=9) received MMF for > or = 6 months as primary treatment (n=9) or subsequent maintenance therapy after CYC treatment (n=8). Treatment outcome was evaluated by random urine protein/creatinine ratio (UP/Cr) and serum creatinine (sCr) at the start and at 12 months and compared by the Wilcoxon signed-rank test. RESULTS: Overall, the mean (+/-SD) UP/Cr decreased in both MN (6.48+/-3.03 vs. 1.31+/-1.22, p= 0.016) and DPLN (3.77+/-2.34 Vs 0.83+/-0.53, p=0.043) patients. No significant change in serum Cr was detected in both MN and DPLN patients. Adverse events included nausea/abdominal discomfort (n=1) and menstrual irregularity (n=1). CONCLUSION: Short term empirical treatment with MMF in the majority of patients with severe MN and DPLN was well tolerated and effective in decrease of proteinuria and stabilization of renal function. Controlled clinical trials are necessary to define the role of MMF in the treatment of severe MN and DPLN.
