Effects of mycophenolate mofetil combined with corticosteroids for induction therapy of microscopic polyangiitis.

Abstract

AIMS We prospectively compared the effects of oral mycophenolate mofetil (MMF) or intravenous cyclophosphamide (IVC) combined with corticosteroids for induction therapy of microscopic polyangiitis (MPA) with renal involvement over a follow-up period of 6 months. METHODS 41 MPA patients were randomly assigned to either the open-label MMF group or the IVC group. Patients in the MMF group (n = 19) received oral MMF 1.0 g/day (1.5 g/day for patients with a body weight >70 kg) and patients in the IVC group (n = 22) received IVC in monthly pulses of 1.0 g per pulse (0.8 g per pulse for patients with a body weight <50 kg). Both groups received intravenous methylprednisolone 360-500 mg/day for 3 days, followed by oral prednisone 0.6-0.8 mg/kg/day and gradual tapering. RESULTS There was no significant difference of estimated glomerular filtration rate (eGFR) level between the IVC and MMF groups at baseline. At 6 months, the eGFR level increased significantly in both groups, but there was no significant difference between the two. Three patients in the IVC group and 1 in the MMF group received maintenance dialysis within 6 months (p = 0.36). The remission rate was 63.6% in the IVC group and 78.9% in the MMF group (p = 0.23). CONCLUSION MMF is effective for inducing remission in Chinese MPA patients and may represent an alternative therapy to monthly impulses of IVC.

DOI: 10.1159/000324364
05020132014201520162017
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@article{Han2011EffectsOM, title={Effects of mycophenolate mofetil combined with corticosteroids for induction therapy of microscopic polyangiitis.}, author={Fei Han and Guangyi Liu and Xiaohui Zhang and Xiayu Li and Qiang He and Xuelin He and Qun Li and Suya Wang and Huiping Wang and Jianghua Chen}, journal={American journal of nephrology}, year={2011}, volume={33 2}, pages={185-92} }