title: Mycophenolate mofetil treatment in children and adolescents with lupus.
abstract: Safety and efficacy data are presented on the use of mycophenolate mofetil (MMF) in 26 children and adolescents with lupus. Data include therapy before and 12 months after starting MMF. 18 of 26 patients had biopsy-proved lupus nephritis. Group 1 were commenced on MMF induction and/or maintenance therapy (n=14), group 2 converted from azathioprine because of inadequate disease control (n=12). 73% of all (10 (71%) group 1 and 10 (83%) group 2) patients experienced a significant improvement in British Isles Lupus Assessment Group score (from median 9.0 to 3.0). Children with hypocomplementaemia increased their C3 significantly in both groups (0.53-1.15 for group 1 and 0.63-1.2 g/l for group 2, p=0.001), and C4 level only in group 1 (0.08-0.17, p=0.01). Renal function and albuminuria improved in those with active nephritis (p≤0.01). Significant improvements were seen in both groups in haemoglobin, erythrocyte sedimentation rate and lymphocyte counts. Prednisolone dose was weaned in both groups, p<0.05. Side-effects were seen in four patients, but none was judged to be severe enough to discontinue treatment. MMF treatment in this cohort of children with lupus seemed to be safe, well tolerated and effective.
authors.affiliation: Department of Paediatrics, Belarus State Medical University, Minsk, Belarus.
authors.forename: Ina
authors.initials: I
authors.lastname: Kazyra
authors.forename: Clarissa
authors.initials: C
authors.lastname: Pilkington
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Marks
authors.forename: Kjell
authors.initials: K
authors.lastname: Tullus
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000276:immunology; D008181:Lupus Nephritis / Q000188:drug therapy; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011239:Prednisolone / Q000008:administration & dosage; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D003176:Complement C3; D003181:Complement C4; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone; D009173:Mycophenolic Acid