Mycophenolate Mofetil or Intravenous Cyclophosphamide for the Initial Induction Therapy of Lupus Nephritis; Clinical Observations.
- Author:
Yong Kyun KIM
1
;
Yeon Sil DO
;
So Yeon CHOI
;
Eun Hee JANG
;
Jung Eun LEE
;
Hoon Suk CHA
;
Wooseong HUH
;
Dae Joong KIM
;
Ha Young OH
;
Ghee Young KWON
;
Eun Mi KOH
;
Yoon Goo KIM
Author Information
1. Department of Internal Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea. yoongookim@samsung.com
- Publication Type:Original Article
- Keywords:
Lupus nephritis;
Mycophenolate mofetil;
Cyclophosphamide
- MeSH:
Creatinine;
Cyclophosphamide*;
Humans;
Lupus Nephritis*;
Lymphocytes;
Prednisolone;
Serum Albumin;
Treatment Failure
- From:Korean Journal of Nephrology
2007;26(2):160-166
- CountryRepublic of Korea
- Language:Korean
-
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.
