Utility of mycophenolate mycophenolate mofetil in lupus nephritis
DOI:
https://doi.org/10.31053/1853.0605.v69.n4.20885Abstract
Mofetil mycophenolate (MM) is an immunosuppressive agent that was initially used to prevent rejection in solid organ transplantation, and was later used to treat systemic autoimmune diseases.
In Systemic Lupus Erythematosus (SLE) it was initially used for the treatment of Lupus Nephropathy (LN) and is now considered an important alternative agent for LN refractory to other drugs as well as in induction therapy with promising results and lower toxicity1-3.
The first studies were limited to describing series with small numbers of patients where MM was used to treat patients with Cyclophosphamide (CF) and Azathioprine (AZA) resistant disease with favorable results.
Subsequently several randomised studies have shown satisfactory results in the treatment of LN in both induction of remission and maintenance compared to the use of CF and AZA6-9.
The good results obtained in the treatment of NL led to the MM being used for the treatment of other manifestations of the disease, such as vasculitis, neurological, skin, haematological and signs or symptoms of disease activity in general.
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ANDERKA MT, LIN AE, ABUELO DN, et al. Reviewing the evidence for mycophenolate mofetil as a new teratogen: case report and review of the literature. Am J Med Genet A 2009; 149A: 1241- 8.
APPEL GB, CONTRERAS G, DOOLEY MA, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol 2009; 20:1103–1112.
GAUBITZ M, SCHORAT A, SCHOTTE H, KERN P, DOMSCHKE W. Mycophenolate mofetil for the treatment of systemic lupus erythematosus: an open pilot trial. Lupus 1999; 8(9): 731-6.
BIJL M, HORST G, BOOTSMA H, LIMBURG PC, KALLENBERG CG. Mycophenolate mofetil prevents a clinical relapse in patients with systemic lupus erythematosus at risk. Ann Rheum Dis 2003; 62(6): 534-9.
KARIM MY, ALBA P, CUADRADO MJ, ET AL. Mycophenolate mofetil for systemic lupus erythematosus refractory to other immunosuppressive agents. Rheumatology (Oxford) 2004; 41(8):876-82.
CHAN TM, LI FK, TANG CS, ET AL. Efficacy of Mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. Hong Kong-Guangzhou Nephrology Study Group. N Engl J Med 2000; 343(16):1156-62.
CHAN TM, TSE KC, TANG CS, MOK MY, LI FK. Long-term Study of Mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis. J Am Soc Nephrol 2005; 16(4):1076-84.
GINZLER EM, DOOLEY MA, ARANOW C, ET AL. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med 2005; 353(21):2219-28.
CONTRERAS PG, PARDO V, LECLERICO B, ET AL. Sequetial therapies for proliferative lupus nephritis. N Engl J Med 2004; 350(10):971-80.
ALLISON AC, EUGUI EM. Mycophenolate mofetil and its mechanisms of action. Immunophacology 2000; 47(2-3):85-118.
ALLISON AC, KOWALSKI WJ, MULLER CJ, WATERS RV, EUGUI EM. Mycophenolate acid and brequinar, inhibitors of purine and pyrimidine synthesis, block the glycosylation of adhesión molecules. Transplant Proc 1993; 25(3 Suppl 2):67-70.
ROCHE LABORATORIES INC. Cellcept (Mycophenolate Mofetil) Product Information, 2007.
MOORE RA, DERRY E. Systematic review and meta-analysis of randomised trials and cohort studies of Mycophenolate mofetil in lupus nephritis. Arthritis Res Ther 2006; 8(6):R182.
PISONI CN, SANCHEZ FJ, KARIM Y, ET AL. Mycophenolate mofetil in systemic lupus erythematosus: Efficacy and tolerability in 86 pacients. J Rheumatol 2005; 32(6):1047-52.
ARMENTI VT, RADOMSKI JS, MORITZ MJ, ET AL. Report from the National Transplantion. Clin Transpl 2005:69-83.
EL SEBAELY Z, CHARPENTIER B, SNANOUDJ R. Fetal malformations associated with Mycophenolate mofetil for lupus nephritis. Nephrol Dial Transplant 2007; 22(9):2722.
PERGOLA E, KANCHARLA A, RILEY DJ. Kidney transplantation during the first trimester of pregnancy: immunosuppression with Mycophenolate mofetil, tacrolimus, and prednisone. Transplantation 2001; 71(7):994-7.
SIFONTIS NM, COSCIA LA, CONSTANTINESCU S, LAVELANET AF, MORITZ MJ, ARMENTI VT. Pregnancy outcomes in solid organ transplnt recipients with exposure to Mycophenolate mofetil or sirolimus. Transplantation 2006; 82(12):1698-702.
Knowledge document Cellcept: CEL 1035; Fertility and Pregnancy outcomes.
A blinded, randomized clinical trial of Mycophenolate mofetil for the prevention of acute rejection in cadaveric renal transplantation. The Tricontinental Mycophenolate Mofetil Renal Transplantation Study Group. Transplantation 1996; 61(7):1029-37.
BUTCHER JA, HARIHARAN S, ADAMS MB, JOHNSON CP, ROZA AM, COHEN EP. Renal transplantation for end-stage renal disease following bone marrow transplantation: a report of six cases, with and without immunosuppression. Clin Transplant 1999; 13(4):330-5.
WANG K, ZHANG H, LI Y, ET AL. Safety of Mycophenolate mofetil versus azathioprine in renal transplantation: a systemic review. Transplant Proc 2004; 36(7):2068-70.
KARIM MY, PISONI CN, FERRO L, ET AL. Reduction of proteinuria with Mycophenolate mofetil in predominantly membranous lupus nephropathy. Rheumatology (Oxford) 2005; 44(10):1317-21.
KASITANON N, PETRI M, HAAS M, MAGDER LS, FINE DM. Mycophenolate mofetil as the primary treatment of membranous lupus nephritis with and without concurrent proliferative disease: a restropective study of 29 cases. Lupus 2008; 17(1):40-5.
SINCLAIR A, APPEL G, DOOLEY MA, ET AL. Mycophenolate mofetil as induction and maintenance therapy for lupus nephritis: rationale and protocol for the randomized, controlled Aspreva Lupus Magnament Study (ALMS). Lupus 2007; 16(12):972-80.
GINZLER, E.M., G.B. APPEL, M.A. DOOLEY, ET AL. (2007). “Mycophenolate mofetil and intravenous cyclophosphamide in racial Group.” Arthritis and Rheumatism 56(12):4308.
ZHU B, CHEN N, LIN Y, ET AL. Mycophenolate mofetil in induction and maintenance therapy of severe lupus nephritis: a meta-analysis of randomized controlled trials. Nephrol Dial Transplant 2007; 22(7):1933-42.
CHAN TM, LI FK, HAO WK, ET AL. Treatment of membranous lupus nephritis with nephrotic síndrome by sequential immunosuppression. Lupus 1999; 8(7):545-51.
TAM LS, LI FK, SZETO CC, ET AL. Treatment of membranous lupus nephritis with prednisone, azathioprine and cyclosporin A. Lupus 2001; 10(11):827-9.
HU W, LIU Z, SHEN S, ET AL. Cyclosporine A in treatment of membranous lupus nephropathy. Chin Med J (Engl) 2003; 116(12):1827-30.
SPETIE DN, TANG Y, ROVIN BH, ET AL. Mycophenolate therapy of SLE membranous nephropathy. Kidney Int 2004; 66(6):2411-5.
KAPITSINOU PP, BOLETIS JN, SKOPOULI FN, BOKI KA, MOUTSOPOULOS HM. Lupus nephritis: treatment with Mycophenolate mofetil. Rheumatology (Oxford) 2004; 43(3)377-80.
WOFSY D, APPEL GB, DOOLEY MA, et al. Aspreva Lupus Management Study maintenance results. Lupus 2010;19(Suppl):27 (CS12.5).
DOOLEY MA, JAYNE D, GINZLER EM, for the ALMS Group. Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis. N Engl J Med 2011;365:1886-95.
HOGAN J, SCHWENK M, RADHAKRISHNAN J. Should mycophenolate mofetil replace cyclophosphamide as first-line therapy for severe lupus nephritis? Kidney Int. 2012 May 30.
LIU LL, JIANG Y, WANG LN, YAO L, LI ZL. Efficacy and Safety of Mycophenolate Mofetil versus Cyclophosphamide for Induction Therapy of Lupus Nephritis: A Meta-Analysis of Randomized Controlled Trials. Drugs. 2012 Jul 30;72(11):1521-33
AL RASHIDI A, ALAJMI M, HEGAZI MO. Mycophenolate mofetil as a maintenance therapy for lupus-related diffuse alveolar hemorrhage: a case report. Lupus 2011 Dec; 20(14):1551-3.
DALL'ERA M. Mycophenolate mofetil in the treatment of systemic lupus erythematosus. Curr Opin Rheumatol. 2011 Sep;23(5):454-8.
KOO HS, KIM YC, LEE SW ET AL. The effects of cyclophosphamide and mycophenolate mofetil on end stage renal disease and death of Lupus nephritis. Lupus 2011; 20:1442-9.
HOUSSIAU FA, D`CRUZ D, SANGLE S ET AL. MAINTAIN Nephritis Trial Group. Azathioprine vs Mycophenolate mofetil for long term immunosuppression in lupus nephritis. Resukts from the MAINTAIN Nephritis Trial. Ann Rheum Dis 2010; 69 ;2083-9.
STOENOIU, MS, AYDIN S, TEKTONIDOU M, et al. Repeated kidney biopsies fail to detect differences between azathioprine and mycophenolate mofetil maintenance therapy for lupus nephritis. Data from the MAINTAIN Nephritis trial. Nephrol Dial Transplant 2012; 27: 1924-30.
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