Comparison of efficacy of continuous mycophenolate mofetil with sequential cyclophosphamide and tacrolimus as maintenance therapy for lupus nephritis

OBJECTIVES: To evaluate the renal response to mycophenolate mofetil (MMF) as maintenance therapy for lupus nephritis (LN) in Japanese patients, we compared the efficacy of MMF and the sequential use of monthly intravenous cyclophosphamide (IVCY) followed by tacrolimus (TAC).

METHODS: We examined 14 patients with LN who were treated with continuous MMF as induction and maintenance therapies (MMF group) and 10 patients with LN who received monthly IVCY as induction therapy followed by maintenance therapy with TAC (IVCY-TAC group). We assessed the therapeutic effects of each treatment regimen on renal manifestations and serological findings over a 36-month period after treatment initiation.

RESULTS: Mean urine protein-to-creatinine ratios in the MMF and IVCY-TAC groups significantly decreased from 2.75 to 0.11 g/gCr and from 3.26 to 0.22 g/gCr, respectively. Significant improvements in serum immunological variables (serum complement C3 or C4 levels and the anti-double-stranded DNA antibody titer) and reductions in the SLE disease activity index and daily prednisolone dosages were observed in both groups during induction therapy and were maintained during maintenance therapy. Efficacy was similar between the MMF and IVCY-TAC groups.

CONCLUSION: MMF has potential as an effective treatment for renal manifestations in Japanese patients throughout induction and maintenance therapies for LN, as an alternative to conventional IVCY-TAC therapy, and as a glucocorticoid-sparing agent.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:33

Enthalten in:

Lupus - 33(2024), 4 vom: 14. März, Seite 319-327

Sprache:

Englisch

Beteiligte Personen:

Kawazoe, Mai [VerfasserIn]
Nanki, Toshihiro [VerfasserIn]

Links:

Volltext

Themen:

8N3DW7272P
Cyclophosphamide
HU9DX48N0T
Immunosuppressive Agents
Journal Article
Lupus nephritis
Mycophenolate mofetil
Mycophenolic Acid
Systemic lupus erythematosus
Tacrolimus
WM0HAQ4WNM

Anmerkungen:

Date Completed 15.03.2024

Date Revised 15.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1177/09612033241228177

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367227487