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Efficacy of Mycophenolate Mofetil in Patients with Diffuse Proliferative Lupus Nephritis

2001; Massachusetts Medical Society; Volume: 344; Issue: 5 Linguagem: Inglês

10.1056/nejm200102013440513

1533-4406

Fotini B. Karassa, David Isenberg,

Inflammatory Bowel Disease

BackgroundThe combination of cyclophospha- mide and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects.Whether mycophenolate mofetil can be substituted for cyclophosphamide is not known. MethodsIn 42 patients with diffuse proliferative lu- pus nephritis we compared the efficacy and side effects of a regimen of prednisolone and mycophenolate mofetil given for 12 months with those of a regimen of prednisolone and cyclophosphamide given for 6 months, followed by prednisolone and azathioprine for 6 months.Complete remission was defined as a value for urinary protein excretion that was less than 0.3 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration, and values for serum creatinine and creatinine clearance that were no more than 15 percent above the base-line values.Partial remission was defined as a value for urinary protein excretion that was between 0.3 and 2.9 g per 24 hours, with a serum albumin concentration of at least 3.0 g per deciliter.