title: Mycophenolate mofetil monotherapy in membranous nephropathy: a 1-year randomized controlled trial.
abstract: BACKGROUND
  Treatment of patients with membranous glomerulonephritis (MGN) is controversial because of the lack of clear benefit of the immunosuppressive regimens on patient or renal survival. The objective of this study is to evaluate the efficacy and safety of mycophenolate mofetil (MMF) for patients with MGN.
  
  
  METHODS
  1-year prospective, randomized, and controlled clinical trial.
  
  
  METHODS
  36 patients with biopsy-proven idiopathic MGN and nephrotic syndrome.
  
  
  METHODS
  19 patients received MMF (2 g/d) for 12 months and 17 patients were in the control group. All patients had the same conservative treatment based on renin-angiotensin blockers, statins, low-salt and low-protein diet, and diuretics in case of edema.
  
  
  METHODS
  End points were the mean proteinuria over creatinuria ratio in mg/g throughout the study and numbers of complete and partial remissions at 1 year (month 12). Data were analyzed on an intention-to-treat analysis.
  
  
  RESULTS
  Mean proteinuria over creatinuria ratio was stable in both groups throughout the study (P = 0.1). Mean proteinuria over creatinuria ratio was 4,690 +/- 2,212 mg/g in the MMF group and 6,548 +/- 4,601 mg/g in the control group (95% confidence interval of the difference, -619 to +4,247; P = 0.1). Remission was complete in 3 patients (1 in the MMF group, 2 in the control group; P = 0.5) and partial in 11 patients (6 in the MMF group, 5 in the control group; P = 0.9). The probability of complete or partial remission did not differ between the 2 groups after 12 months (relative risk, 0.92; 95% confidence interval, 0.48 to 1.75; P = 0.7). Kidney function was stable in the 2 groups according to estimated glomerular filtration rate and serum creatinine level.
  
  
  CONCLUSIONS
  The small number of patients and short follow-up prevent generalizations.
  
  
  CONCLUSIONS
  A 12-month regimen of MMF did not decrease mean proteinuria over creatinuria ratio or increase partial and complete remissions. Serious adverse effects were observed in 4 patients (20%) receiving MMF.
authors.affiliation: Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception et Université Aix-Marseille II, Marseille, France. bdussol@ap-hm.fr
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dussol
authors.forename: Sophie
authors.initials: S
authors.lastname: Morange
authors.forename: Stéphane
authors.initials: S
authors.lastname: Burtey
authors.forename: Monica
authors.initials: M
authors.lastname: Indreies
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cassuto
authors.forename: Georges
authors.initials: G
authors.lastname: Mourad
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Villar
authors.forename: Claire
authors.initials: C
authors.lastname: Pouteil-Noble
authors.forename: Huseyin
authors.initials: H
authors.lastname: Karaaslan
authors.forename: Hélène
authors.initials: H
authors.lastname: Sichez
authors.forename: Catherine
authors.initials: C
authors.lastname: Lasseur
authors.forename: Yashou
authors.initials: Y
authors.lastname: Delmas
authors.forename: Marie-Béatrice
authors.initials: MB
authors.lastname: Nogier
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fathallah
authors.forename: Anderson
authors.initials: A
authors.lastname: Loundou
authors.forename: Valérie
authors.initials: V
authors.lastname: Mayor
authors.forename: Yvon
authors.initials: Y
authors.lastname: Berland
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood / Q000652:urine; D004305:Dose-Response Relationship, Drug; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine; D009173:Mycophenolic Acid