Is mycophenolate mofetil superior to pulse intravenous cyclophosphamide for induction therapy of proliferative lupus nephritis in Egyptian patients?

2010 ◽  
Vol 14 (3) ◽  
pp. 214-221 ◽  
Author(s):  
Eid M. El-Shafey ◽  
Said H. Abdou ◽  
Mohamed M. Shareef
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Induction Therapy ◽  
Intravenous Cyclophosphamide ◽  
Proliferative Lupus Nephritis ◽  
Egyptian Patients

Outcomes of Mycophenolate Mofetil vs. Intravenous Cyclophosphamide in Induction Therapy of Childhood-Onset Lupus Nephritis

2020 ◽  
Vol 103 (8) ◽  
pp. 785-790
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Induction Therapy ◽  
Lupus Erythematosus ◽  
Infectious Complications ◽  
University Hospitals ◽  
Intravenous Cyclophosphamide ◽  
Proliferative Lupus Nephritis ◽  
Study Results ◽  
Significant Difference

Background: Intravenous cyclophosphamide (IVCY) concomitant with corticosteroids demonstrated better outcomes in therapy of proliferative lupus nephritis albeit adverse effects may occur. Mycophenolate mofetil (MMF) is a newer oral medication for treating lupus nephritis. Objective: To compare renal outcomes between IVCY and MMF in conjunction with corticosteroid for induction therapy of proliferative lupus nephritis. Materials and Methods: The authors reviewed the medical records from four university hospitals of children who received prednisolone with either MMF or IVCY for induction therapy of proliferative lupus nephritis between 2005 and 2014 in the present retrospective cohort study. Results: Twenty-eight and 85 patients were included in the MMF and IVCY group, respectively. The respective mean age at MMF and IVCY initiation was 12.36±2.87 and 11.84±3.04 years. Renal remission was not significantly different between the groups (p=0.690). Non-nephrotic range proteinuria (adjusted OR 2.93, 95% CI 1.23 to 6.94, p=0.015), and high initial GFR (adjusted OR 2.93, 95% CI 1.14 to 7.56, p=0.026) were significantly associated with achieving renal remission. Both infectious (82.1%) and non-infectious complications (96.9%) were more common in the IVCY group. Neither death nor end-stage renal disease (ESRD) occurred during the induction therapy. Conclusion: There was no significant difference in renal remission whether children received MMF or IVCY for induction therapy of lupus nephritis; however, adverse events occurred less frequently in the MMF group. Keywords: Children, Lupus nephritis, Systemic lupus erythematosus, Mycophenolate, Cyclophosphamide, Induction

Lupus Nephritis: Induction Therapy

Lupus ◽  
2005 ◽  
Vol 14 (3_suppl) ◽  
pp. 27-32 ◽  
Author(s):  
TM Chan
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Adverse Effects ◽  
Induction Therapy ◽  
Chinese Patients ◽  
Renal Outcome ◽  
Induction Treatment ◽  
Renal Survival ◽  
Proliferative Lupus Nephritis

Effective induction therapy is of pivotal importance in minimizing renal parenchymal damage by the active immune-mediated inflammatory processes in severe proliferative lupus nephritis. Preservation of nephron mass is prerequisite to long-term renal survival. Data from US-based studies have shown improved efficacy with induction treatment comprising corticosteroid and cyclophosphamide, compared with corticosteroid treatment alone. Data from European studies have shown similar efficacy with a modified treatment regimen, in which smaller doses of cyclophosphamide were given at weekly or fortnightly intervals over a shortened treatment duration, and the treatment related adverse effects appeared less frequent with the reduced-dose regimen. We have also reported that sequential immunosuppression with prednisolone and oral cyclophosphamide as induction followed by azathioprine maintenance was associated with a high incidence of remission and relatively favourable long-term renal outcome in Chinese patients. However, cyclophosphamide treatment is associated with considerable adverse effects, which could be potentially fatal. Mycophenolate mofetil selectively inhibits lymphocyte proliferation, and thus targets an instrumental step in the pathogenesis of systemic lupus erythematosus. There is accumulating evidence that the combined use of mycophenolate mofetil and corticosteroid presents an effective treatment for severe proliferative lupus nephritis in different ethnic groups, and is associated with much fewer adverse effects compared with cyclophosphamide-based regimens. Recent data from our group also demonstrate the long-term efficacy of mycophenolate mofetil in preserving renal survival, when used continuously as both induction and maintenance therapy.

scholarly journals Mycophenolate mofetil and intravenous cyclophosphamide are similar as induction therapy for class V lupus nephritis

2010 ◽  
Vol 77 (2) ◽  
pp. 152-160 ◽  
Author(s):  
Jai Radhakrishnan ◽  
Dimitrios-Anestis Moutzouris ◽  
Ellen M. Ginzler ◽  
Neil Solomons ◽  
Ilias I. Siempos ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Induction Therapy ◽  
Intravenous Cyclophosphamide ◽  
Class V
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