Efficacy of Mycophenolate Mofetil in Patients with Diffuse Proliferative Lupus Nephritis

作者：Fotini B. Karassa, David Alan Isenberg · 发表于：New England Journal of Medicine · 年份：2001 · DOI：10.1056/nejm200102013440513 · 被引用次数：541 · 研究领域：Systemic Lupus Erythematosus Research、Renal Diseases and Glomerulopathies、Inflammatory Bowel Disease

BackgroundThe combination of cyclophospha- mide and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects.Whether mycophenolate mofetil can be substituted for cyclophosphamide is not known. MethodsIn 42 patients with diffuse proliferative lu- pus nephritis we compared the efficacy and side effects of a regimen of prednisolone and mycophenolate mofetil given for 12 months with those of a regimen of prednisolone and cyclophosphamide given for 6 months, followed by prednisolone and azathioprine for 6 months.Complete remission was defined as a value for urinary protein excretion that was less than 0.3 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration, and values for serum creatinine and creatinine clearance that were no more than 15 percent above the base-line values.Partial remission was defined as a value for urinary protein excretion that was between 0.3 and 2.9 g per 24 hours, with a serum albumin concentration of at least 3.0 g per deciliter.