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Prospective controlled study on mycophenolate mofetil and prednisolone in the treatment of membranous nephropathy with nephrotic syndrome
Author(s) -
CHAN TAK MAO,
LIN AI WU,
TANG SYDNEY CW,
QIAN JIA QI,
LAM MAN FAI,
HO YIU WING,
TSE KAI CHUNG,
CHAN KWOK WAH,
LAI KAR NENG,
TANG COLIN SO
Publication year - 2007
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2007.00822.x
Subject(s) - medicine , prednisolone , tolerability , nephrotic syndrome , regimen , gastroenterology , urology , proteinuria , creatinine , adverse effect , surgery , kidney
SUMMARY: Background: Retrospective and anecdotal data suggest that mycophenolate mofetil (MMF) might be effective when given as rescue therapy for membranous nephropathy (MN). Prospective controlled data on MMF and prednisolone as primary therapy are lacking. Methods: A prospective, randomized, controlled, open‐label study was performed to investigate the efficacy and tolerability of MMF and prednisolone as primary treatment in MN with nephrotic syndrome. MMF and prednisolone given for 6 months was compared against a modified Ponticelli regimen in 20 patients, with follow up of 15 months. Results: MMF with prednisolone and the comparative immunosuppressive regimen showed similar efficacy in proteinuria reduction, despite a lower cumulative prednisolone dose in the MMF group (3.80 ± 0.28 vs 9.93 ± 0.25 g, P < 0.001). Remission (composite of ‘complete’ and ‘partial’) rates were 63.6% and 66.7% in the MMF group and control group, respectively ( P = 1.000). Serum creatinine and creatinine clearance remained stable during follow up. Cumulative relapse rate was 23.1% at 2 years. Chlorambucil resulted in more leucopenia compared with MMF. Conclusion: Data from this pilot study indicate that more than 60% of patients with MN and nephrotic syndrome respond to combined MMF and prednisolone treatment, and suggest potential benefits of MMF as being steroid‐sparing and having less adverse effects compared with other commonly used cytotoxic agents.