Treatment of lupus nephritis by mycophenolate mofetil.
OBJECTIVE
Mycophenolate mofetil (MMF) has been increasingly used for the treatment of lupus nephritis (LN). The aim of this study was to examine the efficacy and safety of MMF used with low doses of corticosteroids as maintenance therapy in patients with LN.


METHODS
The study covered 35 patients, most of them with proliferative types of LN (5 WHO class III, 26 class IV), while 1 had class V and 3 class VI nephritis. MMF was administered in the dose of 1.5-2 g/24 h and prednisone at 10-20 mg/day. The treatment effects were followed over a 12-month period.


RESULTS
After 3 months of therapy significant reduction in proteinuria was achieved (2.1 +/- 2.4 g/24 h vs. 1.0 +/- 1.0 g/24 h, p < 0.01) and maintained to the end of the study. In parallel, a significant rise in serum albumin, a fall of cholesterol and a significant increase in mean glomerular filtration rate were noted. Complete remission was achieved in 16 patients (45.7%), including all patients in class III and V plus 10 patients in class IV. Not a single adverse effect was observed.


CONCLUSIONS
MMF combined with low doses of steroids is an effective and safe treatment for the maintenance of stable remission of LN.
Rabrenović
Violeta
V
Clinics of Nephrology, Military Medical Academy, Belgrade, Serbia. violetarabrenovic@yahoo.com
Poskurica
Mileta
M
Kovacević
Zoran
Z
Nesić
Vidosava
V
Savin
Marina
M
Mitić
Branka
B
Dimković
Nada
N
Cucković
Cedomir
C
Vujić
Danica
D
Pljesa
Steva
S
Perunicić-Peković
Gordana
G
Curić
Slobodan
S
Mitić
Igor
I
Ratković
Marina
M
Marinković
Jelena
J
Jovanović
Dragan
D
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008181:Lupus Nephritis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011446:Prospective Studies; D012074:Remission Induction
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid