title: Prospective controlled study on mycophenolate mofetil and prednisolone in the treatment of membranous nephropathy with nephrotic syndrome.
abstract: BACKGROUND
  Retrospective and anecdotal data suggest that mycophenolate mofetil (MMF) might be effective when given as rescue therapy for membranous nephropathy (MN). Prospective controlled data on MMF and prednisolone as primary therapy are lacking.
  
  
  METHODS
  A prospective, randomized, controlled, open-label study was performed to investigate the efficacy and tolerability of MMF and prednisolone as primary treatment in MN with nephrotic syndrome. MMF and prednisolone given for 6 months was compared against a modified Ponticelli regimen in 20 patients, with follow up of 15 months.
  
  
  RESULTS
  MMF with prednisolone and the comparative immunosuppressive regimen showed similar efficacy in proteinuria reduction, despite a lower cumulative prednisolone dose in the MMF group (3.80 +/- 0.28 vs 9.93 +/- 0.25 g, P < 0.001). Remission (composite of 'complete' and 'partial') rates were 63.6% and 66.7% in the MMF group and control group, respectively (P = 1.000). Serum creatinine and creatinine clearance remained stable during follow up. Cumulative relapse rate was 23.1% at 2 years. Chlorambucil resulted in more leucopenia compared with MMF.
  
  
  CONCLUSIONS
  Data from this pilot study indicate that more than 60% of patients with MN and nephrotic syndrome respond to combined MMF and prednisolone treatment, and suggest potential benefits of MMF as being steroid-sparing and having less adverse effects compared with other commonly used cytotoxic agents.
authors.affiliation: Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong. dtmchan@hkucc.hku.hk
authors.forename: Tak Mao
authors.initials: TM
authors.lastname: Chan
authors.forename: Ai Wu
authors.initials: AW
authors.lastname: Lin
authors.forename: Sydney Cw
authors.initials: SC
authors.lastname: Tang
authors.forename: Jia Qi
authors.initials: JQ
authors.lastname: Qian
authors.forename: Man Fai
authors.initials: MF
authors.lastname: Lam
authors.forename: Yiu Wing
authors.initials: YW
authors.lastname: Ho
authors.forename: Kai Chung
authors.initials: KC
authors.lastname: Tse
authors.forename: Kwok Wah
authors.initials: KW
authors.lastname: Chan
authors.forename: Kar Neng
authors.initials: KN
authors.lastname: Lai
authors.forename: Colin So
authors.initials: CS
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone; D009173:Mycophenolic Acid