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Mycophenolate therapy of SLE membranous nephropathy
Dan N Spetie1, Yuxiao Tang, Brad H Rovin
1Department of Internal Medicine, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Medical Center, Columbus, Ohio, USA.
Kidney International
|December 1, 2004
Summary
Mycophenolic acid (MMF) shows promise in treating membranous lupus nephritis (SLE MN). Most patients achieved remission and reduced proteinuria with MMF and supportive therapies.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) glomerulonephritis (GN) WHO Classes III and IV are managed with mycophenolic acid (MMF).
- Limited data exists on MMF for membranous lupus nephritis (SLE MN), WHO Class V.
Purpose of the Study:
- To evaluate the efficacy of MMF in patients with SLE MN.
- To assess risk factors for SLE flare in patients receiving MMF therapy.
Main Methods:
- A prospective study involving 13 consecutive SLE MN patients.
- Treatment included prednisone, MMF (mean dose 1173 mg/day), and renoprotective/antiproteinuria interventions.
Main Results:
- Complete or partial remission was achieved in 10 of 13 patients within 6 months.
- At mean follow-up of 16 months, 9 of 13 patients were in complete remission with improved renal function.
- Urine protein/creatinine ratio decreased significantly (< 0.8 in 11/13 patients).
Conclusions:
- Moderate-dose MMF combined with renoprotective therapy is a promising treatment for SLE MN.
- Further research is warranted to confirm these findings and optimize management strategies.