Mycophenolate Mofetil versus Cyclophosphamide for Induction Treatment of Lupus Nephritis

• Type: Article in International Scientific Journal
• Date: 2009

Authors

Appel, GB (Author) Other; Contreras, G (Author) Other; Dooley, MA (Author) Other; Ginzler, EM (Author) Other; Isenberg, D (Author) Other; Jayne, D (Author) Other; Li, LS (Author) Other; Mysler, E (Author) Other; Sanchez Guerrero, J (Author) Other; Solomons, N (Author) Other; Wofsy, D (Author) Other; Abud, C (Author) Other; Adler, S (Author) Other; Alarcon, G (Author) Other; Albuquerque, E (Author) Other; Almeida, F (Author) Other; Alvarellos, A (Author) Other; Appel, G (Author) Other; Avila, H (Author) Other; Blume, C (Author) Other; Boletis, I (Author) Other; Bonnardeaux, A (Author) Other; Braun, A (Author) Other; Buyon, J (Author) Other; Cervera, R (Author) Other; Chen, N (Author) Other; Chen, S (Author) Other; Da Costa, AG (Author) Other; Davids, R (Author) Other; D'Cruz, D (Author) Other; De Ramon, E (Author) Other; Deodhar, A (Author) Other; Doria, A (Author) Other; Dussol, B (Author) Other; Emery, P (Author) Other; Fiechtner, J (Author) Other; Floege, J (Author) Other; Fragoso Loyo, H (Author) Other; Furie, R (Author) Other; Ghazalli, R (Author) Other; Ghossein, C (Author) Other; Gilkeson, G (Author) Other; Ginzler, E (Author) Other; Gordon, C (Author) Other; Grossman, J (Author) Other; Gu, J (Author) Other; Guillevin, L (Author) Other; Hatron, PY (Author) Other; Herrera, G (Author) Other; Hiepe, F (Author) Other; Houssiau, F (Author) Other; Hubscher, O (Author) Other; Hura, C (Author) Other; Kaplan, J (Author) Other; Kirsztajn, G (Author) Other; Kiss, E (Author) Other; Kutty, GA (Author) Other; Laville, M (Author) Other; Lazaro, M (Author) Other; Lenz, O (Author) Other; Li, L (Author) Other; Lightstone, L (Author) Other; Lim, S (Author) Other; Malaise, M (Author) Other; Manzi, S (Author) Other; Marcos, J (Author) Other; Meyer, O (Author) Other; Monge, P (Author) Other; Naicker, S (Author) Other; Neal, N (Author) Other; Neuwelt, M (Author) Other; Nicholls, K (Author) Other; Olsen, N (Author) Other; Ordi Ros, J (Author) Other; Ostrov, B (Author) Other; Pestana M (Author) FMUP; Petri, M (Author) Other; Pokorny, G (Author) Other; Pourrat, J (Author) Other; Qian, J (Author) Other; Radhakrishnan, J (Author) Other; Rovin, B (Author) Other; Roman, JS (Author) Other; Shanahan, J (Author) Other; Shergy, W (Author) Other; Skopouli, F (Author) Other; Spindler, A (Author) Other; Striebich, C (Author) Other; Sundel, R (Author) Other; Swanepoel, C (Author) Other; Si, YT (Author) Other; Tate, G (Author) Other; Tesar, V (Author) Other; Tikly, M (Author) Other; Wang, H (Author) Other; Yahya, R (Author) Other; Yu, X (Author) Other; Zhang, F (Author) Other; Zoruba, D (Author) Other

Journal

Title: Journal of the American Society of Nephrology

Vol. 20

Pages: 1103-1112

ISSN: 1046-6673

Publisher: American Society of Nephrology

Indexing

ISI Web of Knowledge - 769 Citations

Scopus - 891 Citations

Other information

Authenticus ID: P-007-Q5V

DOI: 10.1681/asn.2008101028

Abstract (EN): Recent studies have suggested that mycophenolate mofetil (MMF) may offer advantages over intravenous cyclophosphamide (IVC) for the treatment of lupus nephritis, but these therapies have not been compared in an international randomized, controlled trial. Here, we report the comparison of MMF and IVC as induction treatment for active lupus nephritis in a multinational, two-phase (induction and maintenance) study. We randomly assigned 370 patients with classes III through V lupus nephritis to open-label MMF (target dosage 3 g/d) or IVC (0.5 to 1.0 g/m(2) in monthly pulses) in a 24-wk induction study. Both groups received prednisone, tapered from a maximum starting dosage of 60 mg/d. The primary end point was a prespecified decrease in urine protein/creatinine ratio and stabilization or improvement in serum creatinine. Secondary end points included complete renal remission, systemic disease activity and damage, and safety. Overall, we did not detect a significantly different response rate between the two groups: 104 (56.2%) of 185 patients responded to MMF compared with 98 (53.0%) of 185 to IVC. Secondary end points were also similar between treatment groups. There were nine deaths in the MMF group and five in the IVC group. We did not detect significant differences between the MMF and IVC groups with regard to rates of adverse events, serious adverse events, or infections. Although most patients in both treatment groups experienced clinical improvement, the study did not meet its primary objective of showing that MMF was superior to IVC as induction treatment for lupus nephritis.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10