Treatment of severe IgA nephropathy: mycophenolate mofetil/prednisone compared to cyclophosphamide/prednisone.

Abstract

OBJECTIVE:

To compare the efficacy of mycophenolate mofetil (MMF)/prednisone to cyclophosphamide (CYC)/prednisone in the treatment of severe IgA nephropathy.

METHODS:

Patients (n = 84) with severe IgA nephropathy received either MMF/prednisone (MMF group) or CYC/prednisone (CYC group). The MMF induction dose was 1.5 g/d for 6 months and the maintenance dose was 0.75 - 1.0 g/day for 12 months. The CYC induction dose was 0.8 - 1.0 g/month for 6 months and the maintenance dose was 0.8 - 1.0 g/3 months for 12 months. Laboratory tests, clinical remission rate and side effects were investigated.

RESULTS:

After 18 months of treatment, the total effective rate in the MMF group was significantly higher than that of the CYC group. Patients' 24-hour urinary protein excretion in the MMF group was lower than the CYC group. Patients' plasma albumin and total protein in the MMF group was higher than the CYC group. MMF and prednisone reduced serum lipids, while in the CYC group serum lipids remained unchanged. There was also a lower incidence of adverse effects in the MMF group (4.76%) than in the CYC group (26.2%).

CONCLUSION:

Combination therapy with MMF and prednisone for severe IgA nephropathy achieved a higher remission rate compared to treatment with CYC and prednisone. This therapy also reduced the 24-hour urinary protein and serum lipids while increasing plasma albumin and improving renal function. The incidence of adverse effects was significantly lower in the MMF group compared to the CYC group. *These authors have contributed equally to this work.

• Authors: Xiaowei Liu, Du Dewei, Shiren Sun, Guoshuang Xu, Hongbao Liu, Lijie He, Peng Zhang
• Journal: International journal of clinical pharmacology and therapeutics (Int J Clin Pharmacol Ther) Vol. 52 Issue 2 Pg. 95-102 (Feb 2014) ISSN: 0946-1965 [Print] Germany
• PMID: 24161158 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Immunosuppressive Agents
• Lipids
• Serum Albumin
• Cyclophosphamide
• Mycophenolic Acid
• Prednisone

Topics

• Adult
• Cyclophosphamide (administration & dosage, adverse effects)
• Drug Therapy, Combination
• Female
• Glomerulonephritis, IGA (blood, drug therapy)
• Humans
• Immunosuppressive Agents (administration & dosage)
• Lipids (blood)
• Male
• Mycophenolic Acid (administration & dosage, adverse effects, analogs & derivatives)
• Prednisone (administration & dosage, adverse effects)
• Serum Albumin (analysis)