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Article: Long-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis
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TitleLong-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis
 
AuthorsChan, TM1
Tse, KC1
Tang, CSO1
Mok, MY1
Li, FK1
 
Issue Date2005
 
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.org
 
CitationJournal Of The American Society Of Nephrology, 2005, v. 16 n. 4, p. 1076-1084 [How to Cite?]
DOI: http://dx.doi.org/10.1681/ASN.2004080686
 
AbstractMycophenolate mofetil (MMF) and the sequential use of cydophosphamide followed by azathioprine (CTX-AZA) demonstrate similar short-term efficacy in the treatment of diffuse proliferative lupus nephritis (DPLN), but MMF is associated with less drug toxicity. Results from an extended long-term study, with median follow-up of 63 mo, that investigated the role of MMF as continuous induction-maintenance treatment for DPLN are presented. Thirty-three patients were randomized to receive MMF, and 31 were randomized to the CTX-AZA treatment arm, both in combination with prednisolone. More than 90% in each group responded favorably (complete or partial remission) to induction treatment. Serum creatinine in both groups remained stable and comparable over time. Creatinine clearance increased significantly in the MMF group, but the between-group difference was insignificant. Improvements in serology and proteinuria were comparable between the two groups. A total of 6.3% in the MMF group and 10.0% of CTX-AZA-treated patients showed doubling of baseline creatinine during follow-up (P = 0.667). Both the relapse-free survival and the hazard ratio for relapse were similar between MMF- and CTX-AZA-treated patients (11 and nine patients relapsed, respectively) and between those with MMF treatment for 12 or S24 mo. MMF treatment was associated with fewer infections and infections that required hospitalization (P = 0.013 and 0.014, respectively). Four patients in the CTX-AZA group but none in the MMF group reached the composite end point of end-stage renal failure or death (P = 0.062 by survival analysis). It is concluded that MMF and prednisolone constitute an effective continuous induction-maintenance treatment for DPLN in Chinese patients. Copyright © 2005 by the American Society of Nephrology.
 
ISSN1046-6673
2012 Impact Factor: 8.987
2012 SCImago Journal Rankings: 4.397
 
DOIhttp://dx.doi.org/10.1681/ASN.2004080686
 
ISI Accession Number IDWOS:000227935800030
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorChan, TM
 
dc.contributor.authorTse, KC
 
dc.contributor.authorTang, CSO
 
dc.contributor.authorMok, MY
 
dc.contributor.authorLi, FK
 
dc.date.accessioned2010-09-06T07:23:40Z
 
dc.date.available2010-09-06T07:23:40Z
 
dc.date.issued2005
 
dc.description.abstractMycophenolate mofetil (MMF) and the sequential use of cydophosphamide followed by azathioprine (CTX-AZA) demonstrate similar short-term efficacy in the treatment of diffuse proliferative lupus nephritis (DPLN), but MMF is associated with less drug toxicity. Results from an extended long-term study, with median follow-up of 63 mo, that investigated the role of MMF as continuous induction-maintenance treatment for DPLN are presented. Thirty-three patients were randomized to receive MMF, and 31 were randomized to the CTX-AZA treatment arm, both in combination with prednisolone. More than 90% in each group responded favorably (complete or partial remission) to induction treatment. Serum creatinine in both groups remained stable and comparable over time. Creatinine clearance increased significantly in the MMF group, but the between-group difference was insignificant. Improvements in serology and proteinuria were comparable between the two groups. A total of 6.3% in the MMF group and 10.0% of CTX-AZA-treated patients showed doubling of baseline creatinine during follow-up (P = 0.667). Both the relapse-free survival and the hazard ratio for relapse were similar between MMF- and CTX-AZA-treated patients (11 and nine patients relapsed, respectively) and between those with MMF treatment for 12 or S24 mo. MMF treatment was associated with fewer infections and infections that required hospitalization (P = 0.013 and 0.014, respectively). Four patients in the CTX-AZA group but none in the MMF group reached the composite end point of end-stage renal failure or death (P = 0.062 by survival analysis). It is concluded that MMF and prednisolone constitute an effective continuous induction-maintenance treatment for DPLN in Chinese patients. Copyright © 2005 by the American Society of Nephrology.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationJournal Of The American Society Of Nephrology, 2005, v. 16 n. 4, p. 1076-1084 [How to Cite?]
DOI: http://dx.doi.org/10.1681/ASN.2004080686
 
dc.identifier.doihttp://dx.doi.org/10.1681/ASN.2004080686
 
dc.identifier.epage1084
 
dc.identifier.hkuros99036
 
dc.identifier.isiWOS:000227935800030
 
dc.identifier.issn1046-6673
2012 Impact Factor: 8.987
2012 SCImago Journal Rankings: 4.397
 
dc.identifier.issue4
 
dc.identifier.openurl
 
dc.identifier.pmid15728784
 
dc.identifier.scopuseid_2-s2.0-20444466207
 
dc.identifier.spage1076
 
dc.identifier.urihttp://hdl.handle.net/10722/76669
 
dc.identifier.volume16
 
dc.languageeng
 
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofJournal of the American Society of Nephrology
 
dc.relation.referencesReferences in Scopus
 
dc.titleLong-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong