Treatment of lupus nephritis and primary glomerulonephritis with enteric-coated mycophenolate sodium.
OBJECTIVE
Mycophenolate mofetil is an effective therapy for lupus nephritis (LN) and other glomerulonephritis (GN). However, gastrointestinal (GI) complications can limit its use. Enteric-coated mycophenolate sodium (EC-MPS) has been designed to reduce GI adverse events, but it has not been fully investigated in the treatment of GN.


METHODS
Patients with LN and primary GN who had received EC-MPS were studied for effects on renal function.


RESULTS
30 subjects (17 LN, 13 primary GN) were studied. EC-MPS decreased proteinuria in both LN and GN. In LN, 16 patients had EC-MPS as induction therapy. Of these, 8 patients achieved complete remission (CR), 4 had partial remission (PR) and 1 improved renal function. In primary GN, CR was achieved in 4 out of 5 with minimal change disease, but only 1 did not relapse. PR was achieved in 1 of 4 patients with membranous glomerulopathy, 2 out of 2 patients with focal segmental glomerulosclerosis and 1 out of 2 patients with IgA nephropathy. Infections, anemia and alopecia were observed, but no patient had GI side effects.


CONCLUSIONS
EC-MPS is effective in LN, but not as effective in primary GN. The risk of GI side effects appears to be low, but other side effects can still occur.
Kitiyakara
C
C
Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. kitiyakc@yahoo.com
Ophascharoensuk
V
V
Changsirikulchai
S
S
Ingsathit
A
A
Tankee
P
P
Sangpanich
A
A
Sumethkul
V
V
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001706:Biopsy; D003404:Creatinine / Q000097:blood / Q000652:urine; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011355:Prodrugs; D012074:Remission Induction; D012189:Retrospective Studies; D013608:Tablets, Enteric-Coated / Q000008:administration & dosage; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D011355:Prodrugs; D013608:Tablets, Enteric-Coated; D003404:Creatinine; D009173:Mycophenolic Acid