title: Surveillance for the use of mycophenolate mofetil for adult patients with lupus nephritis in Japan.
abstract: OBJECTIVE
  Mycophenolate mofetil (MMF) is used as one of the standard induction/maintenance protocols for lupus nephritis (LN). However, MMF has not been approved for treating LN in any country, resulting in worldwide off-label use of this immunosuppressant. In order to clarify the real-world use of MMF as a treatment for LN in Japan, Japan College of Rheumatology surveyed the use of MMF in daily clinical practice.
  
  
  METHODS
  Adult patients with LN who visited enrolled hospitals from October 2008 to September 2013 were surveyed for the initial, maximum, and maintenance doses of MMF. The safety and efficacy of MMF were retrospectively evaluated.
  
  
  RESULTS
  One hundred and thirty-seven LN patients including 116 females were enrolled. The median of initial, maximum, and maintenance doses of MMF were 1.0 g/day, 1.5 g/day, and 1.0 g/day, respectively. Sixty-one adverse events were reported in 39 patients during the follow-up period. Median urine protein level decreased from 1.89 g/gCr to 0.21 g/gCr, meanC3 level increased from 66.4 mg/dl to 80.3 mg/dl, and median anti-DNA antibody titer decreased from 40.6 IU/ml to 10.6 IU/ml.
  
  
  CONCLUSIONS
  MMF was commonly used for the treatment of adult LN patients with acceptable efficacy and safety in Japan.
authors: a Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine , Hokkaido , Japan.
authors: Shinsuke
authors: S
authors: Yasuda
authors: a Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine , Hokkaido , Japan.
authors: Tatsuya
authors: T
authors: Atsumi
authors: a Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine , Hokkaido , Japan.
authors: Sanae
authors: S
authors: Shimamura
authors: b Clinical Research and Medical Innovation Center, Hokkaido University Hospital , Hokkaido , Japan.
authors: Kota
authors: K
authors: Ono
authors: c Department of Medicine and Clinical Science , Gunma University Graduate School of Medicine , Gunma , Japan.
authors: Keiju
authors: K
authors: Hiromura
authors: d Department of Medicine and Clinical Science , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan.
authors: Kenei
authors: K
authors: Sada
authors: e Department of Pediatrics , Yokohama City University Medical Center , Yokohama , Japan.
authors: Masaaki
authors: M
authors: Mori
authors: f Kagoshima University Hospital, Children's Medical Center , Kagoshima , Japan.
authors: Syuji
authors: S
authors: Takei
authors: g Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan.
authors: Yasushi
authors: Y
authors: Kawaguchi
authors: h Department of Internal Medicine and Rheumatology , Juntendo University Faculty of Medicine , Tokyo , Japan.
authors: Naoto
authors: N
authors: Tamura
authors: h Department of Internal Medicine and Rheumatology , Juntendo University Faculty of Medicine , Tokyo , Japan.
authors: Yoshinari
authors: Y
authors: Takasaki
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007564:Japan; D008181:Lupus Nephritis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D056687:Off-Label Use; D012074:Remission Induction; D012189:Retrospective Studies; D012219:Rheumatology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: Induction therapy; Mycophenolate mofetil; Mycophenolic acid; Proliferative lupus nephritis; Systemic lupus erythematosus