Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, Korea.
J Korean Med Sci. 2019 Jul 15;34(27):e185. doi: 10.3346/jkms.2019.34.e185.
The objective of this study was to identify the effects of mycophenolate mofetil (MMF) on non-renal manifestations in systemic lupus erythematosus (SLE).
The study population comprised 439 SLE patients from the Korean Lupus Network registry who were followed up annually and completed the baseline survey and two follow-up visits from 2014 to 2018. Disease activity, laboratory markers, and clinical manifestations including mucocutaneous lesions, arthritis, serositis, neurological disorders, and hematologic/immunologic abnormalities were assessed. All variables by group (MMF and non-MMF) effects with time (baseline, 1st follow-up, and 2nd follow-up) were analyzed by generalized estimation equation.
Seventy-two patients were treated with MMF. There was significant difference in frequencies of malar rash, arthritis, renal disorder, and hematologic disorder between MMF and non-MMF groups in total SLE patients. In subgroup analysis of hematologic abnormalities in total patients, frequency of leukopenia was significantly different between the two groups during follow-up ( = 0.001), but frequencies of hemolytic anemia, lymphopenia, and thrombocytopenia were not. In addition, frequencies of leukopenia in patients without lupus nephritis were significantly decreased in MMF group compared to non-MMF group ( = 0.012).
This study showed that MMF might be a beneficial treatment for hematologic abnormalities, especially leukopenia, in SLE.
本研究旨在探讨霉酚酸酯（MMF）对系统性红斑狼疮（SLE）非肾脏表现的影响。
该研究纳入了 2014 年至 2018 年期间韩国狼疮网络注册中心的 439 例 SLE 患者，这些患者每年接受随访，并完成了基线调查和两次随访。评估疾病活动、实验室标志物以及包括黏膜皮肤损伤、关节炎、浆膜炎、神经病变和血液/免疫异常在内的临床表现。采用广义估计方程分析按组（MMF 和非 MMF）和时间（基线、第 1 次随访和第 2 次随访）划分的所有变量的效应。
72 例患者接受 MMF 治疗。在总 SLE 患者中，MMF 组和非 MMF 组在蝶形红斑、关节炎、肾脏疾病和血液疾病方面的发生率存在显著差异。在总患者血液异常亚组分析中，两组在随访期间白细胞减少的发生率存在显著差异（ = 0.001），但溶血性贫血、淋巴细胞减少和血小板减少的发生率无差异。此外，在无狼疮肾炎的患者中，MMF 组的白细胞减少发生率明显低于非 MMF 组（ = 0.012）。
本研究表明，MMF 可能对 SLE 的血液异常，特别是白细胞减少症有治疗作用。
