Gadakchi Leyla, Hajialilo Mehrzad, Nakhjavani Mohammad-Reza, Abedi Azar Sima, Kolahi Sousan, Gojazadeh Morteza, Ebrahimi Ali-Asghar, Malek Mahdavi Aida, Noshad Hamid, Khabbazi Alireza
Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Kidney Dis. 2018 Oct;12(5):288-292.
Lupus nephritis is a common and severe manifestation of systemic lupus erythematosus that can lead to end-stage renal disease and death. The aim of this study was to compare the efficacy and safety of mycophenolate mofetil (MMF) and cyclophosphamide as induction therapy and subsequently as maintenance therapy for lupus nephritis.
In this retrospective case-control study, 67 patients with proliferative lupus nephritis who were treated with MMF (n = 45) and pulse of intravenous cyclophosphamide (n = 22) were included. Remission of the kidney disease, mortality, and adverse events were evaluated and compared between the two groups.
The 45 patients treated with MMF had a mean age of 33.8 ± 10.6 years and 17.1% of them were males. The 22 patients treated with pulse of intravenous cyclophosphamide had a mean age of 38.1 ± 11.1 years and 18.2% of them were males. Complete and partial kidney remission occurred in 40% and 42.2% of the patients treated with MMF and in 31.8% and 59.1% of the patients treated with cyclophosphamide, respectively. No significant differences were observed in complete and partial remission between the two groups. No mortality was reported in the studied patients. There were no significant differences in the frequency of adverse events between the two groups.
The efficacy of MMF in long-term treatment of lupus nephritis was comparable to that of cyclophosphamide, and there is no significant differences in the rate of side effects between the two regimens.
狼疮性肾炎是系统性红斑狼疮常见且严重的表现形式，可导致终末期肾病和死亡。本研究旨在比较霉酚酸酯（MMF）和环磷酰胺作为狼疮性肾炎诱导治疗及后续维持治疗的疗效和安全性。
在这项回顾性病例对照研究中，纳入了67例接受MMF治疗（n = 45）和静脉注射环磷酰胺冲击治疗（n = 22）的增殖性狼疮性肾炎患者。评估并比较两组患者的肾病缓解情况、死亡率和不良事件。
接受MMF治疗的45例患者平均年龄为33.8±10.6岁，其中17.1%为男性。接受静脉注射环磷酰胺冲击治疗的22例患者平均年龄为38.1±11.1岁，其中18.2%为男性。接受MMF治疗的患者中，完全缓解和部分缓解的比例分别为40%和42.2%；接受环磷酰胺治疗的患者中，这一比例分别为31.8%和59.1%。两组之间在完全缓解和部分缓解方面未观察到显著差异。研究患者中未报告死亡病例。两组之间不良事件的发生率无显著差异。
MMF长期治疗狼疮性肾炎的疗效与环磷酰胺相当，两种治疗方案的副作用发生率无显著差异。
