Related Experiment Video

Updated: Jun 2, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Longterm followup after tapering mycophenolate mofetil during maintenance treatment for proliferative lupus nephritis

Katerina Laskari1, Athanasios G Tzioufas, Anna Antoniou

  • 1Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece. katerina_laskari@yahoo.gr

The Journal of Rheumatology
|April 19, 2011
PubMed
Abstract

Insights

Reducing mycophenolate mofetil (MMF) early in lupus nephritis remission increases relapse risk. Tapering MMF more than 18 months after remission appears safe for maintaining remission in proliferative lupus nephritis.

Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • Proliferative lupus nephritis requires long-term immunosuppression.
  • Mycophenolate mofetil (MMF) is a key drug in lupus nephritis maintenance therapy.
  • Optimal timing for MMF dose reduction is not well-established.

Purpose of the Study:

  • To determine the safe timing for reducing mycophenolate mofetil (MMF) dosage during remission-maintenance therapy for proliferative lupus nephritis.

Main Methods:

  • Retrospective evaluation of 44 patients with proliferative lupus nephritis.
  • Analysis of MMF dose reduction in 18 patients.
  • Comparison of relapse rates based on MMF tapering timing.

Main Results:

  • Early MMF reduction (≤ 18 months post-remission) significantly increased relapse risk (6.8-fold for remission, 6.3-fold for complete remission).
  • P-values for early reduction were p = 0.001 and p = 0.011, respectively.
  • Reducing MMF later than 18 months did not correlate with higher relapse rates.

Conclusions:

  • Tapering mycophenolate mofetil (MMF) more than 1.5 years after achieving remission or complete remission is associated with a lower risk of disease flare in proliferative lupus nephritis.
  • This timing allows for potential drug reduction without compromising remission maintenance.

Related Concept Videos

Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
Nephrotic Syndrome II : Assessment and Medical Management01:26

Nephrotic Syndrome II : Assessment and Medical Management

IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document any history...
Pulmonary Tuberculosis V01:28

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
Nephrotic Syndrome III : Nursing Management01:24

Nephrotic Syndrome III : Nursing Management

Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...