Mycophenolate mofetil and systemic lupus erythematosus: an overview

Pisoni, C. N.; Karim, Mohammed Yousuf; Cuadrado, M J

doi:10.1177/096120330501400103

Cited by 38 publications

(32 citation statements)

References 15 publications

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“…Azathioprine is licensed for use in systemic lupus erythematosus, and there is evidence to indicate superiority for maintenance compared with cyclophosphamide, following induction in patients with lupus nephritis 19 . In cutaneous lupus, there are no RCTs to indicate efficacy although several case series suggest that azathioprine may be a useful treatment 20–22 …”

Section: 0 Effective Use Of Azathioprine: Review Of the Evidencementioning

confidence: 99%

British Association of Dermatologists’ guidelines for the safe and effective prescribing of azathioprine 2011

Meggitt

Anstey

Mustapa

et al. 2011

British Journal of Dermatology

113

151

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Section: 0 Effective Use Of Azathioprine: Review Of the Evidencementioning

confidence: 99%

British Association of Dermatologists’ guidelines for the safe and effective prescribing of azathioprine 2011

Meggitt

Anstey

Mustapa

et al. 2011

British Journal of Dermatology

113

151

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“…These were all case series or open‐label trials, but the limited evidence suggested that mycophenolate mofetil was effective for refractory hematologic and dermatologic manifestations of SLE (15). A retrospective review of the records of 93 patients with SLE found that mycophenolate mofetil was associated with a clinically significant reduction in steroid dosage, European Consensus Lupus Activity Measure score, erythrocyte sedimentation rate, and anti–double‐stranded DNA (anti‐dsDNA) antibody titer, with an increase in complement C3 levels (16). Therefore, the potential nonrenal benefits of mycophenolate mofetil warrant further study.…”

mentioning

confidence: 99%

Nonrenal disease activity following mycophenolate mofetil or intravenous cyclophosphamide as induction treatment for lupus nephritis: Findings in a multicenter, prospective, randomized, open‐label, parallel‐group clinical trial

Ginzler

Wofsy

Isenberg

et al. 2009

Arthritis & Rheumatism

146

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Objective. To assess the effect of mycophenolate mofetil compared with intravenous pulses of cyclophosphamide on the nonrenal manifestations of lupus nephritis.Methods. Patients with active lupus nephritis (renal biopsy class III, IV, or V) were recruited for the study (n ‫؍‬ 370) and treated with mycophenolate mofetil (target dosage 3 gm/day) or intravenous cyclophosphamide (0.5-1.0 gm/m 2 /month), plus tapered prednisone, for 24 weeks. Nonrenal outcomes were determined using measures of whole body disease activity, including the British Isles Lupus Assessment Group (BILAG) disease activity index, the Safety of Estrogens in Lupus Erythematosus: National Assessment (SELENA) version of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and immunologic variables.Results. Both treatments were effective on whole body disease activity in the systems examined, as indicated by changes in the classic BILAG index. With either treatment, remission was induced, notably in the mucocutaneous, musculoskeletal, cardiovascular/ respiratory, and vasculitis systems, and flares were rare, as measured by the SELENA-SLEDAI. Levels of complement C3, C4, and CH50 and titers of anti-double-stranded DNA antibodies were normalized after treatment with either mycophenolate mofetil or intravenous cyclophosphamide.Conclusion. In addition to the efficacy of both treatments on the renal system, this analysis showed that remission could also be induced in other systems. There was no clear difference in efficacy between mycophenolate mofetil and intravenous cyclophosphamide in ameliorating either the renal or nonrenal manifestations. Mycophenolate mofetil is, therefore, a suitable alternative to cyclophosphamide for the treatment of renal and nonrenal disease manifestations in patients with biopsy-proven lupus nephritis.

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“…17 MMF, associated with less drug toxicity, was a potential alternative immunosuppressive to CTX for the treatment of LN. 18 In this study, we had the observation that MMF therapy in crescentic LN as good as CTX would be an important one, so MMF is actually better, for it has less side effects than CTX.…”

Section: Discussionmentioning

confidence: 99%