Department of Paediatrics, Belarus State Medical University, Minsk, Belarus.
Arch Dis Child. 2010 Dec;95(12):1059-61. doi: 10.1136/adc.2009.178608. Epub 2010 Aug 31.
Safety and efficacy data are presented on the use of mycophenolate mofetil (MMF) in 26 children and adolescents with lupus. Data include therapy before and 12 months after starting MMF. 18 of 26 patients had biopsy-proved lupus nephritis. Group 1 were commenced on MMF induction and/or maintenance therapy (n=14), group 2 converted from azathioprine because of inadequate disease control (n=12). 73% of all (10 (71%) group 1 and 10 (83%) group 2) patients experienced a significant improvement in British Isles Lupus Assessment Group score (from median 9.0 to 3.0). Children with hypocomplementaemia increased their C3 significantly in both groups (0.53-1.15 for group 1 and 0.63-1.2 g/l for group 2, p=0.001), and C4 level only in group 1 (0.08-0.17, p=0.01). Renal function and albuminuria improved in those with active nephritis (p≤0.01). Significant improvements were seen in both groups in haemoglobin, erythrocyte sedimentation rate and lymphocyte counts. Prednisolone dose was weaned in both groups, p<0.05. Side-effects were seen in four patients, but none was judged to be severe enough to discontinue treatment. MMF treatment in this cohort of children with lupus seemed to be safe, well tolerated and effective.
我们报告了吗啉代吗啉乙酯（MMF）在 26 例狼疮患儿和青少年中的安全性和疗效数据。资料包括治疗前和开始 MMF 治疗后 12 个月的数据。26 例患者中有 18 例经活检证实为狼疮肾炎。1 组患者接受 MMF 诱导和/或维持治疗（n=14），2 组患者因疾病控制不理想而改用硫唑嘌呤（n=12）。所有患者中（10 例（71%）组 1 和 10 例（83%）组 2）的 73%均出现英国狼疮评估组评分显著改善（中位数从 9.0 降至 3.0）。两组低补体血症患儿的 C3 均显著增加（组 1 为 0.53-1.15，组 2 为 0.63-1.2 g/l，p=0.001），而 C4 仅在组 1 中增加（0.08-0.17，p=0.01）。有活动性肾炎的患者肾功能和蛋白尿均改善（p≤0.01）。两组的血红蛋白、红细胞沉降率和淋巴细胞计数均有显著改善。两组的泼尼松剂量均逐渐减少（p<0.05）。四例患者出现副作用，但均未严重到需要停药。在这组狼疮患儿中，MMF 治疗似乎安全、耐受良好且有效。
