Mycophenolate mofetil versus intravenous cyclophosphamide for induction treatment of proliferative lupus nephritis in a Japanese population: A retrospective study

Akira Onishi, Daisuke Sugiyama, Go Tsuji, Takashi Nakazawa, Yoshinori Kogata, Kosaku Tsuda, Ikuko Naka, Keisuke Nishimura, Kenta Misaki, Chiyo Kurimoto, Hiroki Hayashi, Goichi Kageyama, Jun Saegusa, Takeshi Sugimoto, Seiji Kawano, Shunichi Kumagai, Akio Morinobu

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Abstract

Objectives: Recent studies have shown that mycophenolate mofetil (MMF) is similar to intravenous cyclophosphamide (IVC) for the treatment of lupus nephritis (LN), but that treatment response may vary according to location and race/ethnicity. Moreover, no studies have been conducted to compare the efficacy of MMF with that of IVC for a Japanese population. We therefore conducted a retrospective study to clarify the efficacy and safety of MMF compared with that of IVC for induction therapy for active LN, classes III and IV, in a Japanese population of 21 patients, 11 of whom received MMF and 10 IVC. Methods: The primary endpoint was expressed as the percentage of responders, who in turn were defined as the patients who met complete or partial response criteria according to the European consensus statement. The secondary endpoints comprised the renal activity component and serological activity. Results: The primary endpoint was achieved in nine (81.8 %) patients receiving MMF and in four (40.0 %) receiving IVC, with no significant difference between the two groups (p = 0.081), while there was also no significant difference between them in terms of secondary endpoints. However, the MMF group suffered significantly fewer hematologic toxic effects than the IVC group. Conclusions: MMF may be used as an alternative to IVC for inducing renal remission of LN in Japanese patients.

Original languageEnglish
Pages (from-to)89-96
Number of pages8
JournalModern rheumatology
Volume23
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1
Externally publishedYes

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Keywords

  • Cyclophosphamide
  • Japanese population
  • Lupus nephritis
  • Mycophenolate mofetil
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

Cite this

Onishi, A., Sugiyama, D., Tsuji, G., Nakazawa, T., Kogata, Y., Tsuda, K., Naka, I., Nishimura, K., Misaki, K., Kurimoto, C., Hayashi, H., Kageyama, G., Saegusa, J., Sugimoto, T., Kawano, S., Kumagai, S., & Morinobu, A. (2013). Mycophenolate mofetil versus intravenous cyclophosphamide for induction treatment of proliferative lupus nephritis in a Japanese population: A retrospective study. Modern rheumatology, 23(1), 89-96. https://doi.org/10.1007/s10165-012-0634-9