title: Treatment of severe IgA nephropathy: mycophenolate mofetil/prednisone compared to cyclophosphamide/prednisone.
abstract: OBJECTIVE
  To compare the efficacy of mycophenolate mofetil (MMF)/prednisone to cyclophosphamide (CYC)/prednisone in the treatment of severe IgA nephropathy.
  
  
  METHODS
  Patients (n = 84) with severe IgA nephropathy received either MMF/prednisone (MMF group) or CYC/prednisone (CYC group). The MMF induction dose was 1.5 g/d for 6 months and the maintenance dose was 0.75 - 1.0 g/day for 12 months. The CYC induction dose was 0.8 - 1.0 g/month for 6 months and the maintenance dose was 0.8 - 1.0 g/3 months for 12 months. Laboratory tests, clinical remission rate and side effects were investigated.
  
  
  RESULTS
  After 18 months of treatment, the total effective rate in the MMF group was significantly higher than that of the CYC group. Patients' 24-hour urinary protein excretion in the MMF group was lower than the CYC group. Patients' plasma albumin and total protein in the MMF group was higher than the CYC group. MMF and prednisone reduced serum lipids, while in the CYC group serum lipids remained unchanged. There was also a lower incidence of adverse effects in the MMF group (4.76%) than in the CYC group (26.2%).
  
  
  CONCLUSIONS
  Combination therapy with MMF and prednisone for severe IgA nephropathy achieved a higher remission rate compared to treatment with CYC and prednisone. This therapy also reduced the 24-hour urinary protein and serum lipids while increasing plasma albumin and improving renal function. The incidence of adverse effects was significantly lower in the MMF group compared to the CYC group. *These authors have contributed equally to this work.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Liu
authors.forename: Du
authors.initials: D
authors.lastname: Dewei
authors.forename: Shiren
authors.initials: S
authors.lastname: Sun
authors.forename: Guoshuang
authors.initials: G
authors.lastname: Xu
authors.forename: Hongbao
authors.initials: H
authors.lastname: Liu
authors.forename: Lijie
authors.initials: L
authors.lastname: He
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
mesh_terms: D000328:Adult; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008055:Lipids / Q000097:blood; D008297:Male; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011241:Prednisone / Q000008:administration & dosage* / Q000009:adverse effects; D012709:Serum Albumin / Q000032:analysis
chemical_list: D007166:Immunosuppressive Agents; D008055:Lipids; D012709:Serum Albumin; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D011241:Prednisone