title: Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review.
abstract: BACKGROUND
  IgA nephropathy is the most common primary glomerular disease worldwide and also the most frequent cause of kidney failure. Mycophenolate mofetil (MMF) is a selective immunosuppressant widely used in many autoimmune diseases. However, the benefits and risks of MMF for the treatment of IgA nephropathy remain uncertain.
  
  
  METHODS
  A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to assess the efficacy and safety of MMF in IgA nephropathy patients, using the statistical software Review Manager 5.1.
  
  
  RESULTS
  Eight RCTs involving 357 patients were identified and included in this review. Overall, no statistical difference was found in the therapeutic effect of MMF treatment compared with other therapies. MMF had no significant effects on reducing proteinuria or protecting renal function. However, subgroup analysis indicated that relatively short-term therapy (<18 months) might be beneficial in IgA nephropathy patients while longer term MMF use conferred no advantage. There was also no statistical difference between MMF and control groups in the incidence of side effects. When compared with other immunosuppressants, MMF was considered superior to cyclophosphamide in terms of better therapeutic effects and fewer adverse reactions, but no difference was found between MMF and leflunomide.
  
  
  CONCLUSIONS
  Our current evidence indicates that a relatively short course of MMF may be beneficial in treating IgA nephropathy. However, high-quality RCTs with large sample size as well as a well-designed study to evaluate the long-term effects of MMF are needed to further evaluate the efficacy and safety of MMF in this disease.
authors.forename: Youyuan
authors.initials: Y
authors.lastname: Chen
authors.forename: YuMin
authors.initials: Y
authors.lastname: Li
authors.forename: ShengLin
authors.initials: S
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China. liangmnfyy@126.com.
authors.forename: Min
authors.initials: M
authors.lastname: Liang
mesh_terms: D003404:Creatinine / Q000097:blood; D004334:Drug Administration Schedule; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000209:etiology; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011507:Proteinuria / Q000517:prevention & control
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine; D009173:Mycophenolic Acid