[Mycophenolate mofetil as a novel treatment for lupus nephritis]

Systemic Lupus erythematosus often involves the kidney. Classification created by the World Health Organization (I-V) grades patients with lupus nephritis, as diagnosed by renal biopsy and those with high grade nephritis (III and above) for treatment in order to preserve renal survival. Today the accepted treatment includes combination of steroids and cycLophosphamide. Mycophenolate mofetil (MMF, Cellcept), is an immunosuppressive agent that inhibits the purine de novo synthesis pathway. Mycophenotate mofetil mainly inhibits the proliferation of Lymphocytes and is commonly used for rejection prevention after solid organ transplantations. Three meta-analyses were performed with several hundred patients in each. ALL meta-analyses showed, with statistical significance (p < 0.05), an advantage in remission rates for MMF with a relative risk (RR) of 1.5 to 3.0. All meta-anaLyses reported statisticaLLy significant Lower rates of infectious complications (RR between 0.65 to 0.5) and amenorrhea was seen with a lower rate in all meta-analyses, although it was statically significant only in one. Treatment with MMF is associated with increased rates of gastrointestinal side effects, although only one meta-analysis showed this in a statisticaLly significant manner.