The accumulated experience with the use of mycophenolate mofetil in primary glomerulonephritis.
BACKGROUND
The use of mycophenolate mofetil (MMF) has been extended from renal transplantation to the treatment of glomerulonephritis. MMF has been used in patients with steroid- and ciclosporin A (CsA)-dependent or -resistant idiopathic nephrotic syndrome and in patients with deteriorating renal function or adverse reactions to other drugs. MMF has been also used in patients with membranous and IgA nephropathy after failure of other regimens as well as initial treatment.


METHODS
The rationale of MMF treatment in primary glomerulonephritis is based in its antifibrotic and antiproteinuric effects. The mechanism of action is described; the results of cohort and randomized trials in minimal change disease, focal segmental glomerulosclerosis, idiopathic membranous nephropathy and IgA nephropathy are presented along with the adverse reactions profile and the expert opinion.


RESULTS
This is an up-to-date review providing insight on this novel agent that is increasingly used in the therapeutics of primary glomerulonephritis.


CONCLUSIONS
Although the results are conflicting, MMF seems to be effective at least in some patients, who do not respond to corticosteroids, ciclosporin or cytotoxic drugs. However, the experience with MMF in primary glomerulonephritis is limited and further research is required in order to establish MMF in the treatment of patients with glomerular disease.
Koukoulaki
Maria
M
University Hospital of Patras, Department of Internal Medicine-Nephrology, Rio-Patra, Greece.
Goumenos
Dimitrios S
DS
D000818:Animals; D002986:Clinical Trials as Topic; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005355:Fibrosis; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology
D004791:Enzyme Inhibitors; D009173:Mycophenolic Acid