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Usefulness of mycophenolate mofetil in Indian patients with C3 glomerulopathy

Joyita Bharati1, Karalanglin Tiewsoh2, Ashwani Kumar3

  • 1Department of Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Clinical Kidney Journal
|August 7, 2019
PubMed
Abstract

Insights

Mycophenolate mofetil (MMF) shows promise in treating C3 glomerulopathy (C3G), a rare kidney disease. This study found that MMF treatment led to remission in two-thirds of Indian patients with C3G.

Area of Science:

  • Nephrology
  • Immunology
  • Complement System

Background:

  • C3 glomerulopathy (C3G) is a rare kidney disease characterized by alternative complement pathway dysregulation.
  • Currently, no standardized treatment exists for C3G, presenting a significant unmet medical need.
  • Mycophenolate mofetil (MMF), an immunosuppressant, has shown potential in Western studies for C3G management.

Purpose of the Study:

  • To evaluate the clinical outcomes of C3 glomerulopathy (C3G) patients treated with mycophenolate mofetil (MMF) in an Indian population.
  • To assess the efficacy and safety of MMF, with or without steroids, in managing C3G.

Main Methods:

  • Retrospective analysis of clinical and histological data from 17 Indian C3G patients treated with MMF for at least six months.
  • Follow-up duration was a minimum of 12 months.
  • Data included baseline serum creatinine, proteinuria, and treatment response to MMF.

Main Results:

  • The majority of patients (88.2%) presented with nephrotic syndrome, with median proteinuria of 3.7 g/day.
  • Two-thirds (64%) of patients responded to MMF therapy, achieving complete remission in 23% and partial remission in 41%.
  • Three patients progressed to end-stage renal disease (ESRD), with two being non-responsive to MMF from the outset.

Conclusions:

  • Mycophenolate mofetil (MMF) demonstrates effectiveness in treating C3 glomerulopathy (C3G) in an Asian cohort, supporting its use in this population.
  • This study provides a foundation for larger, randomized controlled trials to further establish MMF's role in C3G management.
  • The findings highlight the potential of MMF as a therapeutic option for C3G patients, particularly in regions where standardized treatments are lacking.
Keywords:
C3 glomerulopathymycophenolate mofetilresponse

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