The Efficacy of Mycophenolate Mofetil on Treatment of New Lupus Nephritis

AUTHORS

Houshang Sanadgol 1 , * , Zahra Zakeri 1 , Iraj Najafi 2 , Mahmoud Akbarian 3

AUTHORS INFORMATION

1 Assistant professor, Department of Internal Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

2 Assistant professor, Department of Internal medicine, Tehran University of Medical Sciences, Tehran, Iran.

3 Full professor, Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.

ARTICLE INFORMATION

Hormozgan Medical Journal: 9 (2); e90311
Published Online: June 13, 2005
Article Type: Research Article
Received: March 02, 2005
Accepted: June 13, 2005

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Abstract

Introduction: Mycophenolate mofetil (MMF) is a new immunouppressive agenty
that selectively inhibits activated lymphoctes and renal mesangial cells.
Experience with MMF in solid – organ transplantation has shown the safety of
this drug and its superiority over azathioprine (AZA) in the prevention of acute
graft rejection. In this study, treatment improvement of lupus nephritis is
investigated, using Mycophenolate Mofetil.
Methods: We performed a nonrandomized clinical trial in 12 patients with
various forms of lupus nephritis (two patients with class V, five patients with
class III, four patients with class IV) were treated with oral MMF at a dose of
2gr/day and for a mean of 5.38 months range 4-6).
All patients were new cases and received concomitant prednisolone. We started
treatment with MMF in all new cases of lupus nephritis. Treatment outcome was
monitored through assessment of systemic Lupus Erythematosus Disease Activity
Index (SLEDAI) score, renal function, proteinuria and serologic markers such as
serum complement and anti dsDNA antibodies. Data were analyzed using Kruscal
wallis and Willcoxon statistical tests.
Results: While serum createnine remained normal (in 8 patients) or increased less
than 33% (in 3 patients). Proteinuria was decreased in 9 cases and Antids DNA
was negative in 5 cases. Complete improvement and nelatine improvement of the
patients were 36.4% and 45.6%, respectively.
Conclusion: Mycophenolate mofetil may represent a valuable alternative to
traditional cytotoxic agents for treatment of nephritis. MMF appeared to be
effective in controlling serologic disease activity in SLE. Adverse events such as
infections may limit its use and remain a concern. MMF should be considered in
the treatment of both new cases and resistant lupus nephritis. Controlled clinical
trials are required to confirm these findings.

Keywords

Lupus Nephritis – Prednisolone - Mycophenolic Acid

© 2005, Hormozgan Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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