Mycophenolate mofetil as maintenance therapy for childhood-onset systemic lupus erythematosus patients with severe lupus nephritis.

Abstract

OBJECTIVES:

We evaluated histological changes occurring in renal biopsy specimens, between the time before initial induction therapy and after 12 months' maintenance therapy, as well as changes in laboratory parameters, SLE disease activity (SLEDAI), and dosage of corticosteroid (CS) in childhood-onset systemic lupus erythematosus (SLE) patients treated with mycophenolate mofetil (MMF).

METHODS:

A retrospective analysis was performed on nine patients diagnosed with childhood-onset SLE and lupus nephritis. They were treated with pulsed mPSL and intravenous cyclophosphamide as induction therapy and MMF (500-1500 mg/day) plus CS as maintenance therapy. Renal biopsy was performed before the initial induction therapy and after 12 months' maintenance therapy.

RESULTS:

Pathological findings at second biopsy were improved in eight of nine patients (89%). The findings of SLEDAI, urinalysis, and blood tests also showed improvement. CS doses could be tapered satisfactorily. Adverse events were observed in two patients. No patients treated with MMF experienced any disease flares during maintenance therapy.

CONCLUSIONS:

MMF as maintenance therapy might be useful in that not only the histological findings of lupus nephritis were improved, but also CS doses could be beneficially tapered. Nonetheless, this is a retrospective report of only nine cases and further prospective multicenter studies are necessary.

• Authors: Toshitaka Kizawa, Tomo Nozawa, Masako Kikuchi, Kiyotaka Nagahama, Koji Okudela, Takako Miyamae, Tomoyuki Imagawa, Tomoko Nakamura, Masaaki Mori, Shumpei Yokota, Hiroyuki Tsutsumi
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 25 Issue 2 Pg. 210-4 (Mar 2015) ISSN: 1439-7609 [Electronic] England
• PMID: 25159157 (Publication Type: Journal Article)

Chemical References

• Immunosuppressive Agents
• Cyclophosphamide
• Mycophenolic Acid
• Methylprednisolone

Topics

• Adolescent
• Child
• Cyclophosphamide (therapeutic use)
• Drug Therapy, Combination
• Female
• Humans
• Immunosuppressive Agents (therapeutic use)
• Kidney (pathology)
• Lupus Erythematosus, Systemic (drug therapy, pathology)
• Lupus Nephritis (drug therapy, pathology)
• Male
• Methylprednisolone (therapeutic use)
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Retrospective Studies
• Treatment Outcome