Korean Journal of Nephrology 2007;26(2):160-166.
Original Article : Mycophenolate Mofetil or Intravenous Cyclophosphamide for the Initial Induction Therapy of Lupus Nephritis; Clinical Observations
Yong Kyun Kim, M.D.1, Yeon Sil Do, M.D.1, So Yeon Choi, M.D.1, Eun Hee Jang, M.D.1,Jung Eun Lee, M.D.1, Hoon-Suk Cha, M.D.1, Wooseong Huh, M.D.1, Dae Joong Kim, M.D.1,Ha-Young Oh, M.D.1, Ghee Young Kwon, M.D.2, Eun-Mi Koh, M.D.1 and Yoon Goo Kim, M.D.1
Department of Internal Medicine1
Pathology2
Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea.
임상연구 : 루푸스 신염 관해 유도 치료로서 Mycophenolate Mofetil과 Cyclophosphamide 치료 효과
김용균1
성균관대학교 의과대학 내과학교실1, 병리학교실2
Abstract
Purpose
The combination of intravenous cyclophosphamide (CYC) and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Mycophenolate mofetil (MMF) Is a new immunosuppressive agent that selectively inhibits activated lymphocytes. This study reports on the clinical experiences at our clinic with MMF and intravenous CYC for the initial induction treatment in patients with lupus nephritis.
Methods
50 patients with lupus nephritis received induction therapy consisting of MMF and prednisolone (n=22) or intravenous CYC and prednisolone (n=28), and followed up for six months. Complete remission was defined as a value for urinary protein: urinary creatinine ratio (Up/Cr) that was less than 0.3, with normal urinary sediment, a normal serum albumin concentration and values for serum creatinine that were no more than 15 percent above the base-line values. Partial remission was defined as a value for Up/Cr that was between 0.3 and 2.9, with a serum albumin concentration of at least 3.0g/dL.
Results
22 patients treated with MMF and 28 patients with intravenous CYC resulted in complete remission (31.8% vs 39.3%), partial remission (45.5% vs 39.3%) and treatment failure (22.7% vs 21.4%). Fewer severe infections occurred among patients treated with MMF and prednisolone.
Conclusion
As for the induction therapy of lupus ephritis, the combination of MMF and prednisolone may be an effective regimen. However, further randomized, prospective studies are needed to prove the effectiveness of MMF therapy in lupus nephritis. Key Words : Lupus nephritis, Mycophenolate mofetil, Cyclophosphamide
Key Words: Lupus nephritis, Mycophenolate mofetil, Cyclophosphamide
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