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Article: Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis

TitleEfficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis
Authors
Issue Date2000
PublisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/
Citation
New England Journal Of Medicine, 2000, v. 343 n. 16, p. 1156-1162 How to Cite?
AbstractBackground: The combination of cyclophosphamide and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Whether mycophenolate mofetil can be substituted for cyclophosphamide is not known. Methods: In 42 patients with diffuse proliferative lupus nephritis we compared the efficacy and side effects of a regimen of prednisolone and mycophenolate mofetil given for 12 months with those of a regimen of prednisolone and cyclophosphamide given for 6 months, followed by prednisolone and azathioprine for 6 months. Complete remission was defined as a value for urinary protein excretion that was less than 0.3 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration, and values for serum creatinine and creatinine clearance that were no more than 15 percent above the base-line values. Partial remission was defined as a value for urinary protein excretion that was between 0.3 and 2.9 g per 24 hours, with a serum albumin concentration of at least 3.0 g per deciliter. Results: Eighty-one percent of the 21 patients treated with mycophenolate mofetil and prednisolone (group 1) had a complete remission, and 14 percent had a partial remission, as compared with 76 percent and 14 percent, respectively, of the 21 patients treated with cyclophosphamide and prednisolone followed by azathioprine and prednisolone (group 2). The improvements in the degree of protelnuria and the serum albumin and creatinine concentrations were similar in the two groups. One patient in each group discontinued treatment because of side effects. Infections were noted in 19 percent of the patients in group 1 and in 33 percent of those in group 2 (P=0.29). Other adverse effects occurred only in group 2; they included amenorrhea (in 23 percent of the patients), hair loss (19 percent), leukopenia (10 percent), and death (10 percent). The rates of relapse were 15 percent and 11 percent, respectively. Conclusions: For the treatment of diffuse proliferative lupus nephritis, the combination of mycophenolate mofetil and prednisolone is as effective as a regimen of cyclophosphamide and prednisolone followed by azathioprine and prednisolone. (C) 2000, Massachusetts Medical Society.
Persistent Identifierhttp://hdl.handle.net/10722/43071
ISSN
2015 Impact Factor: 59.558
2015 SCImago Journal Rankings: 14.619
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLi, FKen_HK
dc.contributor.authorTang, CSOen_HK
dc.contributor.authorWong, RWSen_HK
dc.contributor.authorFang, GXen_HK
dc.contributor.authorJi, YLen_HK
dc.contributor.authorLau, CSen_HK
dc.contributor.authorWong, AKMen_HK
dc.contributor.authorTong, MKLen_HK
dc.contributor.authorChan, KWen_HK
dc.contributor.authorLai, KNen_HK
dc.date.accessioned2007-03-23T04:38:09Z-
dc.date.available2007-03-23T04:38:09Z-
dc.date.issued2000en_HK
dc.identifier.citationNew England Journal Of Medicine, 2000, v. 343 n. 16, p. 1156-1162en_HK
dc.identifier.issn0028-4793en_HK
dc.identifier.urihttp://hdl.handle.net/10722/43071-
dc.description.abstractBackground: The combination of cyclophosphamide and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Whether mycophenolate mofetil can be substituted for cyclophosphamide is not known. Methods: In 42 patients with diffuse proliferative lupus nephritis we compared the efficacy and side effects of a regimen of prednisolone and mycophenolate mofetil given for 12 months with those of a regimen of prednisolone and cyclophosphamide given for 6 months, followed by prednisolone and azathioprine for 6 months. Complete remission was defined as a value for urinary protein excretion that was less than 0.3 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration, and values for serum creatinine and creatinine clearance that were no more than 15 percent above the base-line values. Partial remission was defined as a value for urinary protein excretion that was between 0.3 and 2.9 g per 24 hours, with a serum albumin concentration of at least 3.0 g per deciliter. Results: Eighty-one percent of the 21 patients treated with mycophenolate mofetil and prednisolone (group 1) had a complete remission, and 14 percent had a partial remission, as compared with 76 percent and 14 percent, respectively, of the 21 patients treated with cyclophosphamide and prednisolone followed by azathioprine and prednisolone (group 2). The improvements in the degree of protelnuria and the serum albumin and creatinine concentrations were similar in the two groups. One patient in each group discontinued treatment because of side effects. Infections were noted in 19 percent of the patients in group 1 and in 33 percent of those in group 2 (P=0.29). Other adverse effects occurred only in group 2; they included amenorrhea (in 23 percent of the patients), hair loss (19 percent), leukopenia (10 percent), and death (10 percent). The rates of relapse were 15 percent and 11 percent, respectively. Conclusions: For the treatment of diffuse proliferative lupus nephritis, the combination of mycophenolate mofetil and prednisolone is as effective as a regimen of cyclophosphamide and prednisolone followed by azathioprine and prednisolone. (C) 2000, Massachusetts Medical Society.en_HK
dc.format.extent104921 bytes-
dc.format.extent26624 bytes-
dc.format.extent64634 bytes-
dc.format.mimetypeapplication/pdf-
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dc.languageengen_HK
dc.publisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/en_HK
dc.relation.ispartofNew England Journal of Medicineen_HK
dc.rightsNew England Journal of Medicine. Copyright © Massachusetts Medical Society.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshGlucocorticoids - therapeutic useen_HK
dc.subject.meshImmunosuppressive agents - adverse effects - therapeutic useen_HK
dc.subject.meshLupus nephritis - drug therapyen_HK
dc.subject.meshMycophenolic acid - adverse effects - analogs & derivatives - therapeutic useen_HK
dc.subject.meshPrednisolone - therapeutic useen_HK
dc.titleEfficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0028-4793&volume=343&issue=16&spage=1156&epage=1162&date=2000&atitle=Efficacy+of+mycophenolate+mofetil+in+patients+with+diffuse+proliferative+lupus+nephritis.+Hong+Kong-Guangzhou+Nephrology+Study+Groupen_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.emailLau, CS: cslau@hku.hken_HK
dc.identifier.emailChan, KW: hrmtckw@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.identifier.authorityLau, CS=rp01348en_HK
dc.identifier.authorityChan, KW=rp00330en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1056/NEJM200010193431604en_HK
dc.identifier.pmid11036121-
dc.identifier.scopuseid_2-s2.0-0034687429en_HK
dc.identifier.hkuros60904-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034687429&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume343en_HK
dc.identifier.issue16en_HK
dc.identifier.spage1156en_HK
dc.identifier.epage1162en_HK
dc.identifier.isiWOS:000089882800004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK
dc.identifier.scopusauthoridTang, CSO=8681865300en_HK
dc.identifier.scopusauthoridWong, RWS=34875928200en_HK
dc.identifier.scopusauthoridFang, GX=7201871525en_HK
dc.identifier.scopusauthoridJi, YL=14026764000en_HK
dc.identifier.scopusauthoridLau, CS=14035682100en_HK
dc.identifier.scopusauthoridWong, AKM=7403147057en_HK
dc.identifier.scopusauthoridTong, MKL=7202033848en_HK
dc.identifier.scopusauthoridChan, KW=16444133100en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK

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