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The safety and efficacy of MMF in lupus nephritis: a pilot study

A G McLean

E Psimenou

A Davenport

S H Powis

P Sweny

A Burns

Centre for Nephrology, Royal Free and University College Medical School, University College London, London, UK

Inducing and maintaining remission in patients with lupus nephritis may be difficult. Current treatments have significant toxicity. Mycophenolate mofetil (MMF) limits damage in murine models of lupus nephritis. We have assessed the efficacy and tolerability of MMF in the treatment of patients with long-standing or resistant lupus nephritis. We have treated 13 patients with biopsy proven lupus nephritis (two membranous nephropathy, four membranous nephropathy with super-imposed proliferative changes, seven with proliferative glomerulonephritis). All patients had relapsed on conventional treatment or there were pressing indications to minimise steroid dosage or avoid alkylating agents. Nine out of 13 were treated with MMF and prednisolone, 3=10 with MMF alone and 1=10 with MMF, prednisolone and cyclosporine. Thirteen patients were treated with MMF for up to 37 months (median 25 months). Three patients were withdrawn from MMF during the first 8 months of treatment. The remainder tolerated MMF (median dose 1 g/day). Serological improvements were observed in 9=13 and steroid dosage was reduced in 8=10 patients. Infections occurred in 3=13. One patient relapsed. MMF significantly reduced the rate of decline of renal function. MMF should be considered in the treatment of long-standing or resistant lupus nephritis. Controlled clinical trials are required to confirm these findings.

Key Words: Mycophenolate mofetil • lupus nephritis • systemic lupus erythematosus • chronic renal failure • immunosuppression

Lupus, Vol. 10, No. 9, 606-611 (2001)
DOI: 10.1191/096120301682430186


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