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Article: Quality of life comparison between corticosteroid-and-mycofenolate mofetil and corticosteroid-and-oral cyclophosphamide in the treatment of severe lupus nephritis

TitleQuality of life comparison between corticosteroid-and-mycofenolate mofetil and corticosteroid-and-oral cyclophosphamide in the treatment of severe lupus nephritis
Authors
Issue Date2006
PublisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.com
Citation
Lupus, 2006, v. 15 n. 6, p. 371-379 How to Cite?
AbstractThere is accumulating evidence that mycophenolate mofetil (MMF), when combined with corticosteroid, is an effective induction treatment for severe proliferative lupus nephritis and is associated with fewer adverse effects compared to cyclophosphamide (CTX), but the quality of life (QOL) associated with these regimens as perceived by the patient has not been compared. This study included patients who had experienced both treatment regimens, for distinct episodes of diffuse proliferative lupus nephritis. QOL parameters during the first six months of each treatment were assessed through SF36 and WHOQOL questionnaires. Twelve patients and 24 episodes of severe lupus nephritis were studied. CTX-treated and MMF-treated episodes showed comparable baseline characteristics and response rate, with complete remission occurring in 83.3%. MMF treatment was associated with higher numerical scores for all domains across both QOL instruments than CTX. MMF treatment was associated with significantly less fatigue, less impediment of physical and social functioning, and better psychological well being compared to CTX. When each patient served as her/his own control, most patients ascribed higher QOL domain scores to the MMF-treated episode. Seventy-five percent of patients found MMF treatment more acceptable and preferred when compared with CTX, and the complications that most concerned them included Cushingoid features, alopecia, menstrual disturbance and infections. These data showed that MMF-based induction immunosuppression for severe lupus nephritis was associated with better QOL than CTX as perceived by patients, which was most likely attributed to the reduced side-effects during MMF treatment. © 2006 Edward Arnold (Publishers) Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/76918
ISSN
2015 Impact Factor: 2.118
2015 SCImago Journal Rankings: 0.878
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, KCen_HK
dc.contributor.authorTang, CSOen_HK
dc.contributor.authorLio, WIen_HK
dc.contributor.authorLam, MFen_HK
dc.contributor.authorChan, TMen_HK
dc.date.accessioned2010-09-06T07:26:19Z-
dc.date.available2010-09-06T07:26:19Z-
dc.date.issued2006en_HK
dc.identifier.citationLupus, 2006, v. 15 n. 6, p. 371-379en_HK
dc.identifier.issn0961-2033en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76918-
dc.description.abstractThere is accumulating evidence that mycophenolate mofetil (MMF), when combined with corticosteroid, is an effective induction treatment for severe proliferative lupus nephritis and is associated with fewer adverse effects compared to cyclophosphamide (CTX), but the quality of life (QOL) associated with these regimens as perceived by the patient has not been compared. This study included patients who had experienced both treatment regimens, for distinct episodes of diffuse proliferative lupus nephritis. QOL parameters during the first six months of each treatment were assessed through SF36 and WHOQOL questionnaires. Twelve patients and 24 episodes of severe lupus nephritis were studied. CTX-treated and MMF-treated episodes showed comparable baseline characteristics and response rate, with complete remission occurring in 83.3%. MMF treatment was associated with higher numerical scores for all domains across both QOL instruments than CTX. MMF treatment was associated with significantly less fatigue, less impediment of physical and social functioning, and better psychological well being compared to CTX. When each patient served as her/his own control, most patients ascribed higher QOL domain scores to the MMF-treated episode. Seventy-five percent of patients found MMF treatment more acceptable and preferred when compared with CTX, and the complications that most concerned them included Cushingoid features, alopecia, menstrual disturbance and infections. These data showed that MMF-based induction immunosuppression for severe lupus nephritis was associated with better QOL than CTX as perceived by patients, which was most likely attributed to the reduced side-effects during MMF treatment. © 2006 Edward Arnold (Publishers) Ltd.en_HK
dc.languageengen_HK
dc.publisherSage Publications Ltd. The Journal's web site is located at http://lup.sagepub.comen_HK
dc.relation.ispartofLupusen_HK
dc.rightsLupus. Copyright © Sage Publications Ltd.en_HK
dc.subject.meshActivities of Daily Livingen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAlopecia - chemically induceden_HK
dc.subject.meshAmenorrhea - chemically induceden_HK
dc.subject.meshCyclophosphamide - adverse effects - therapeutic useen_HK
dc.subject.meshDrug Evaluationen_HK
dc.subject.meshFatigue - etiology - prevention & controlen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunosuppressive Agents - adverse effects - therapeutic useen_HK
dc.subject.meshInfection - chemically induceden_HK
dc.subject.meshKidney Function Testsen_HK
dc.subject.meshLupus Nephritis - drug therapy - pathology - psychologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMycophenolic Acid - adverse effects - analogs & derivatives - therapeutic useen_HK
dc.subject.meshPatient Acceptance of Health Careen_HK
dc.subject.meshPrednisolone - adverse effects - therapeutic useen_HK
dc.subject.meshQuality of Lifeen_HK
dc.subject.meshRemission Inductionen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.titleQuality of life comparison between corticosteroid-and-mycofenolate mofetil and corticosteroid-and-oral cyclophosphamide in the treatment of severe lupus nephritisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0961-2033&volume=15&issue=6&spage=371&epage=379&date=2006&atitle=Quality+of+life+comparison+between+corticosteroid-and-mycofenolate+mofetil+and+corticosteroid-and-oral+cyclophosphamide+in+the+treatment+of+severe+lupus+nephritisen_HK
dc.identifier.emailChan, TM:dtmchan@hku.hken_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1191/0961203306lu2307xxen_HK
dc.identifier.pmid16830884-
dc.identifier.scopuseid_2-s2.0-33745812399en_HK
dc.identifier.hkuros117900en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33745812399&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume15en_HK
dc.identifier.issue6en_HK
dc.identifier.spage371en_HK
dc.identifier.epage379en_HK
dc.identifier.isiWOS:000238439800008-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridTang, CSO=8681865300en_HK
dc.identifier.scopusauthoridLio, WI=14035914000en_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.citeulike697679-

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