霉酚酸酯与环磷酰胺治疗狼疮性肾炎的比较。

A Comparison Of Mycophenolate Mofetil And Cyclophosphamide As Lupus Nephritis Induction Therapy.

机构信息

Department of Rheumatology, Fauji Foundation Hospital Rawalpindi, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2020 Oct-Dec;32(4):454-458.

Abstract

BACKGROUND

Lupus nephritis and its induction therapies are understudied subjects in rheumatology especially in our population. The objective of this study is to compare the renal response to Mycophenolate mofetil (MMF) and Cyclophosphamide (CYC) as induction therapy in the Pakistani population with lupus nephritis.

METHODS

This is a comparative retrospective study conducted at the department of rheumatology, Fauji Foundation Hospital (FFH), Rawalpindi, and the duration of the study was 1.5 years from July 2016 to December 2017. The study includes 28 patients, all females, ages between 18 to 50 years. All have biopsy proven lupus nephritis (LN). All 28 LN patients have either stage III, IV, V. They were investigated and analysed over 1.5 years. 14 patients were given MMF (2.5 gram/day) (MMF group) and 14 patients were given CYC (NIH protocol/monthly) (CYC group) for 24 weeks as induction therapy. Comparison of baseline characteristics, complete and partial renal responses to treatment was seen in the MMF and CYC groups.

RESULTS

Primary end point (complete response) is achieved in 6 (42.85%) in MMF group and 5 (35.71%) in the CYC group. The secondary end point (partial response) was achieved in 5 (35.71%) patients in the MMF group and 6(42.85%) in the CYC group. The difference in the cumulative probability of complete and partial response was not statistically significant between the two groups (P-0.470 for CR) and (p-value 0.132 for PR).

CONCLUSIONS

Mycophenolate mofetil is a new therapy for LN and it has equal efficacy as compared to CYC for LN induction.

摘要

背景

狼疮肾炎及其诱导治疗在风湿病学中研究较少，尤其是在我们的人群中。本研究的目的是比较霉酚酸酯（MMF）和环磷酰胺（CYC）作为诱导治疗在巴基斯坦狼疮肾炎患者中的肾脏反应。

方法

这是一项在拉瓦尔品第 Fauji 基金会医院（FFH）风湿病科进行的比较回顾性研究，研究时间为 2016 年 7 月至 2017 年 12 月，为期 1.5 年。研究包括 28 名女性患者，年龄在 18 至 50 岁之间。所有患者均经活检证实为狼疮肾炎（LN）。所有 28 例 LN 患者均为 III、IV、V 期。他们在 1.5 年内接受了调查和分析。14 名患者给予 MMF（2.5 克/天）（MMF 组），14 名患者给予 CYC（NIH 方案/每月）（CYC 组），作为诱导治疗 24 周。比较 MMF 和 CYC 组的基线特征、完全和部分肾脏治疗反应。

结果

主要终点（完全缓解）在 MMF 组中达到 6 例（42.85%），在 CYC 组中达到 5 例（35.71%）。次要终点（部分缓解）在 MMF 组中达到 5 例（35.71%），在 CYC 组中达到 6 例（42.85%）。两组间完全和部分缓解的累积概率差异无统计学意义（CR 组 P-0.470，PR 组 p 值 0.132）。