mycophenolate mofetil as maintenance therapy for proliferative lupus nephritis a long-term observational prospective study霉酚酸酯作为维持治疗增生性狼疮肾炎长期观测的前瞻性研究.pdfVIP

Laskari et al. Arthritis Research Therapy 2010, 12:R208 /content/12/6/R208 RESEARCH ARTICLE Open Access Mycophenolate mofetil as maintenance therapy for proliferative lupus nephritis: a long-term observational prospective study 1 2 1 1* Katerina Laskari , Clio P Mavragani , Athanasios G Tzioufas , Haralampos M Moutsopoulos Abstract Introduction: While the role of mycophenolate mofetil (MMF) in the management of lupus nephritis has been increasingly recognized, limited information is available regarding its efficacy and safety as a long-term maintenance treatment. The aim of the present study was to evaluate the efficacy and safety profile of MMF as maintenance therapy for proliferative lupus nephritis. Methods: Thirty-three consecutive patients with proliferative lupus nephritis received induction therapy with five to seven monthly intravenous (iv) pulses of cyclophosphamide (CYC) plus iv steroids followed by oral MMF 2 g/day as maintenance therapy for a median time of 29 months (range 9 to 71 months). Primary end points were the achievement of renal remission, complete renal remission, disease remission - renal and extrarenal -, the occurrence of renal relapse, chronic renal failure and death. Secondary end points were the extrarenal disease activity and drug adverse events. The clinical and laboratory parameters were compared during follow-up by means of nonparametric statistical tests. Time to event analysis was performed according to the Kaplan-Meier method. Results: A significant improvement of all renal parameters was observed at the end of the induction treatment and at the latest follow-up compared to baseline. The rate of patients achieving renal remission until the end of follow-up was 73%, whereas