title: Pilot 24 month study to compare mycophenolate mofetil and tacrolimus in the treatment of membranous lupus nephritis with nephrotic syndrome.
abstract: OBJECTIVE
  This pilot study compared mycophenolate mofetil (MMF) and tacrolimus (Tac) in the treatment of severe membranous lupus nephritis (MLN).
  
  
  METHODS
  This was a 24 month prospective, randomized, open-label multi-centre exploratory study on Chinese patients with biopsy-proven pure Class V MLN with nephrotic syndrome. Patients were randomized to treatment with either MMF or Tac, both in combination with prednisolone and the efficacy and tolerability outcomes were examined.
  
  
  RESULTS
  Sixteen patients were included, seven in the MMF and nine in the Tac treatment arm. At 24 months the complete response, partial response and overall response rates were 57.1% vs. 11.1% (P = 0.049), 14.3% vs. 44.4% (P = 0.197) and 71.4% vs. 55.6% (P = 0.515) in the MMF and Tac groups, respectively. The two groups had similar reduction of proteinuria and longitudinal profiles of serum albumin and creatinine levels. Serum creatinine remained stable in both groups, except in two patients who had a transient increase associated with high Tac blood levels. Adverse events in the MMF group included herpes zoster in one patient and reversible leucopenia in another, while in the Tac group four patients had severe infections and one developed new onset diabetes. No relapse occurred during the study period.
  
  
  CONCLUSIONS
  Both MMF and Tac when combined with corticosteroids are effective treatment options for severe MLN.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Desmond Y H
authors.initials: DY
authors.lastname: Yap
authors.forename: Xueqing
authors.initials: X
authors.lastname: Yu
authors.forename: Xiang-Mei
authors.initials: XM
authors.lastname: Chen
authors.forename: Fuming
authors.initials: F
authors.lastname: Lu
authors.forename: Nan
authors.initials: N
authors.lastname: Chen
authors.forename: Xue-Wang
authors.initials: XW
authors.lastname: Li
authors.forename: Colin So
authors.initials: CS
authors.lastname: Tang
authors.forename: Tak Mao
authors.initials: TM
authors.lastname: Chan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D002681:China; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008181:Lupus Nephritis / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D010865:Pilot Projects; D011239:Prednisolone / Q000627:therapeutic use; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D012709:Serum Albumin; D011239:Prednisolone; D003404:Creatinine; D009173:Mycophenolic Acid; D016559:Tacrolimus