Aringer M, Fischer-Betz R, Hiepe F
Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Z Rheumatol. 2013 Aug;72(6):575-80. doi: 10.1007/s00393-013-1213-y.
Mycophenolate mofetil (MMF) is among the few immunosuppressive drugs with sufficient data from controlled studies on the therapy of systemic lupus erythematosus (SLE). In the light of results from recently published randomized controlled trials on the effectiveness of MMF in the treatment of lupus nephritis, it has become necessary to revise the statement of the Germany Society of Rheumatology on the use of MMF for SLE. In the induction therapy of lupus nephritis MMF has been shown to be equivalent in effectiveness to i.v. cyclophosphamide and superior to azathioprine in the maintenance phase. Cyclophosphamide is inferior to MMF and probably also to azathioprine as maintenance therapy and should therefore, not be considered for this purpose and also because of its toxicity. For other organ manifestations MMF also constitutes an alternative when approved immunosuppressants are not able to control the disease and glucocorticoids cannot be reduced to 7.5 mg prednisolone daily equivalents or less.
霉酚酸酯(MMF)是少数几种有足够对照研究数据用于系统性红斑狼疮(SLE)治疗的免疫抑制药物之一。鉴于最近发表的关于MMF治疗狼疮性肾炎有效性的随机对照试验结果,有必要修订德国风湿病学会关于MMF用于SLE的声明。在狼疮性肾炎的诱导治疗中,MMF已被证明在有效性上等同于静脉注射环磷酰胺,且在维持阶段优于硫唑嘌呤。作为维持治疗,环磷酰胺不如MMF,可能也不如硫唑嘌呤,因此,不应考虑将其用于此目的,也是由于其毒性。对于其他器官表现,当批准的免疫抑制剂无法控制疾病且糖皮质激素不能减至每日等效泼尼松龙7.5mg或更低时,MMF也可作为一种替代选择。