| Abstract | Studies of immunosuppressive therapy, particularly mycophenolate mofetil (MMF), in membranous lupus nephritis (MLN) are limited. We report on our experience with primary (first-line) MMF therapy to induce and sustain renal remission in MLN with and without a concurrent proliferative lesion. Systemic lupus erythematosus (SLE) patients were studied, retrospectively, if treated with MMF for newly diagnosed MLN. Complete remission was defined as proteinuria less than 0.5 g/24 h, inactive urine sediment and normal estimated glomerular filtration rate. Response in pure MLN (Group I, n=10) was compared with mixed MLN and proliferative lupus nephritis (Group II, n=19). By 12 months, 4 (40%) patients in Group I and 7 (36.8%) in Group II achieved complete remission (P=0.87). One (10%) patient in Group I and 2 (10.5%) in Group II had worsening renal disease (P=0.97). Mean time to remission was more than seven months in both groups. The remaining patients had stable disease without improvement or worsening. Only 2 of 11 achieving initial remission had a relapse with an average of 28 months of follow-up after remission. Self-limited gastrointestinal symptoms occurred in 12 patients, none requiring withdrawal of the drug. Mycophenolate mofetil as a primary therapy in MLN was successful in inducing complete remission in about 40% of MLN, particularly in patients with mild proteinuria. However, 12 months of therapy was necessary for best outcomes. Response rate was not different in the presence or absence of a proliferative lesion. |
| Authors | N Kasitanon, M Petri, M Haas, L S Magder, D M Fine
(Affiliation: Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.)
|
| Journal | Lupus
(Lupus)
Vol. 17
Issue 1
Pg. 40-5
( 2008)
ISSN: 0961-2033 England |
| PMID | 18089682
(Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural)
|
| Chemical References |
- Immunosuppressive Agents
- mycophenolate mofetil
- Mycophenolic Acid
|
| Topics |
- Adolescent
- Adult
- Female
- Glomerular Filtration Rate
(drug effects)
- Glomerulonephritis, Membranous
(classification, complications, drug therapy, physiopathology)
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Lupus Nephritis
(classification, complications, drug therapy, physiopathology)
- Male
- Mycophenolic Acid
(adverse effects, analogs & derivatives, therapeutic use)
- Recurrence
- Remission Induction
- Retrospective Studies
- Time Factors
- Treatment Outcome
|
