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Article: Long-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis

TitleLong-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis
Authors
Issue Date2005
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.org
Citation
Journal Of The American Society Of Nephrology, 2005, v. 16 n. 4, p. 1076-1084 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/76669
ISSN
2014 Impact Factor: 9.343
2014 SCImago Journal Rankings: 4.302
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, TMen_HK
dc.contributor.authorTse, KCen_HK
dc.contributor.authorTang, CSOen_HK
dc.contributor.authorMok, MYen_HK
dc.contributor.authorLi, FKen_HK
dc.date.accessioned2010-09-06T07:23:40Z-
dc.date.available2010-09-06T07:23:40Z-
dc.date.issued2005en_HK
dc.identifier.citationJournal Of The American Society Of Nephrology, 2005, v. 16 n. 4, p. 1076-1084en_HK
dc.identifier.issn1046-6673en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76669-
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.en_HK
dc.languageengen_HK
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.orgen_HK
dc.relation.ispartofJournal of the American Society of Nephrologyen_HK
dc.titleLong-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1046-6673&volume=16&issue=4&spage=1076&epage=1084&date=2005&atitle=Long-term+study+of+mycophenolate+mofetil+as+continuous+induction+and+maintenance+treatment+for+diffuse+proliferative+lupus+nephritisen_HK
dc.identifier.emailChan, TM:dtmchan@hku.hken_HK
dc.identifier.emailMok, MY:temy@hkucc.hku.hken_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.identifier.authorityMok, MY=rp00490en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1681/ASN.2004080686en_HK
dc.identifier.pmid15728784-
dc.identifier.scopuseid_2-s2.0-20444466207en_HK
dc.identifier.hkuros99036en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-20444466207&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume16en_HK
dc.identifier.issue4en_HK
dc.identifier.spage1076en_HK
dc.identifier.epage1084en_HK
dc.identifier.isiWOS:000227935800030-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridTang, CSO=55225422400en_HK
dc.identifier.scopusauthoridMok, MY=7006024184en_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK

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