title: Mycophenolate as induction therapy in lupus nephritis with renal function impairment.
abstract: BACKGROUND
  Mycophenolate (MF) is effective as induction therapy for lupus nephritis (LN) in patients with normal renal function; however, little is known about its role in patients with impaired renal failure. The purpose of this study was to evaluate the response to MF in LN and its association with baseline renal function.
  
  
  METHODS
  Data were obtained for 90 patients from 12 Spanish renal units who were receiving MF as induction therapy for LN. Patients were classified into 2 groups: group 1 (estimated glomerular filtration rate [eGFR] ≥60 ml/min/1.73 m(2)) and group 2 (eGFR <60 ml/min/ 1.73 m(2)). The primary outcome measure was the percentage of patients who achieved any response and its relationship with initial eGFR. The secondary outcome measures were the percentage of patients who achieved a complete response (CR) or partial response (PR) and the appearance of relapses during treatment and side effects.
  
  
  RESULTS
  At initiation of MF treatment, there were no differences in the main parameters between group 1 (n = 63; eGFR 87 ± 23 ml/min/ 1.73 m(2)) and group 2 (n = 27; eGFR 44 ± 12 ml/min/1.73 m(2)). Exposure to prednisone and MF was similar. The percentages of patients who achieved a response in groups 1 and 2 were, respectively, 69.2 and 43.8% at 6 months and 81.3 and 73.7% at 12 months. CR was more frequent in group 1, whereas PR was similar in both groups. Four patients relapsed and side effects were unremarkable.
  
  
  CONCLUSIONS
  MF is effective and safe as induction therapy for LN, and response is even achieved in patients with baseline renal impairment.
authors.affiliation: Hospital General de Ciudad Real, Ciudad Real, España. friverahdez @ senefro.org
authors.forename: F
authors.initials: F
authors.lastname: Rivera
authors.forename: X
authors.initials: X
authors.lastname: Fulladosa
authors.forename: R
authors.initials: R
authors.lastname: Poveda
authors.forename: M A
authors.initials: MA
authors.lastname: Frutos
authors.forename: P
authors.initials: P
authors.lastname: García-Frías
authors.forename: J
authors.initials: J
authors.lastname: Ara
authors.forename: L
authors.initials: L
authors.lastname: Illescas
authors.forename: E
authors.initials: E
authors.lastname: López-Rubio
authors.forename: E
authors.initials: E
authors.lastname: Mérida
authors.forename: A
authors.initials: A
authors.lastname: Carreño
authors.forename: J
authors.initials: J
authors.lastname: Ballarín
authors.forename: G
authors.initials: G
authors.lastname: Fernández-Juárez
authors.forename: J
authors.initials: J
authors.lastname: Baltar
authors.forename: C
authors.initials: C
authors.lastname: Ramos
authors.forename: S
authors.initials: S
authors.lastname: Pons
authors.forename: A
authors.initials: A
authors.lastname: Oliet
authors.forename: A
authors.initials: A
authors.lastname: Vigil
authors.forename: M
authors.initials: M
authors.lastname: Praga
authors.forename: A
authors.initials: A
authors.lastname: Segarra
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008181:Lupus Nephritis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use*; D012074:Remission Induction; D051437:Renal Insufficiency / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D011241:Prednisone