Mycophenolate in Refractory and Relapsing Lupus Nephritis
Background: Mycophenolate (MF) is effective as induction and maintenance treatment in patients with lupus nephritis (LN). This study evaluates the efficacy and safety of MF in patients with refractory and relapsing LN. Methods: Data were retrospectively obtained for 85 patients (35 refractory and 50...
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| Veröffentlicht in: | American journal of nephrology 2014-01, Vol.40 (2), p.105-112 |
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| creator | Rivera, Francisco Mérida, Evangelina Illescas, Maria L. López-Rubio, E. Frutos, Miguel A. García-Frías, Patricia Ramos, Carmela Sierra, María Baltar, José Lucas, Jesús Oliet, Aniana Vigil, Ana Fernández-Juárez, Gema Segarra, Alfons Praga, Manuel |
| description | Background: Mycophenolate (MF) is effective as induction and maintenance treatment in patients with lupus nephritis (LN). This study evaluates the efficacy and safety of MF in patients with refractory and relapsing LN. Methods: Data were retrospectively obtained for 85 patients (35 refractory and 50 relapsing) from 11 nephrology departments in Spain. The primary endpoints were the incidence and cumulative number of renal responses and relapses and their relationship with baseline clinical and analytical data. The secondary endpoint was the appearance of side effects. Results: The main clinical and analytical variables were similar both in refractory and relapsing LN. Most of the patients had received cyclophosphamide, and all of them switched to MF. 74 patients (87%) achieved a response (69% partial, 31% complete). Age at starting MF, gender, pathological classification, body mass index, blood pressure, baseline renal function, and proteinuria were not associated with achieving response. After stopping MF, 3 of 19 patients (15.7%) relapsed, all at 6 months of follow-up. No differences were found between clinical and analytical variables and number of relapses. Side effects were unremarkable, except for 1 patient, who died of thrombocytopenia and ovarian hemorrhage. Conclusions: Switching to MF from other immunosuppressive treatments is effective and safe in refractory and relapsing LN. |
| doi_str_mv | 10.1159/000365256 |
| format | Article |
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This study evaluates the efficacy and safety of MF in patients with refractory and relapsing LN. Methods: Data were retrospectively obtained for 85 patients (35 refractory and 50 relapsing) from 11 nephrology departments in Spain. The primary endpoints were the incidence and cumulative number of renal responses and relapses and their relationship with baseline clinical and analytical data. The secondary endpoint was the appearance of side effects. Results: The main clinical and analytical variables were similar both in refractory and relapsing LN. Most of the patients had received cyclophosphamide, and all of them switched to MF. 74 patients (87%) achieved a response (69% partial, 31% complete). Age at starting MF, gender, pathological classification, body mass index, blood pressure, baseline renal function, and proteinuria were not associated with achieving response. After stopping MF, 3 of 19 patients (15.7%) relapsed, all at 6 months of follow-up. No differences were found between clinical and analytical variables and number of relapses. Side effects were unremarkable, except for 1 patient, who died of thrombocytopenia and ovarian hemorrhage. Conclusions: Switching to MF from other immunosuppressive treatments is effective and safe in refractory and relapsing LN.</description><identifier>ISSN: 0250-8095</identifier><identifier>EISSN: 1421-9670</identifier><identifier>DOI: 10.1159/000365256</identifier><identifier>PMID: 25096639</identifier><identifier>CODEN: AJNED9</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adolescent ; Adult ; Aged ; Cyclophosphamide - therapeutic use ; Diarrhea - chemically induced ; Drug Substitution ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Immunosuppressive Agents - adverse effects ; Immunosuppressive Agents - therapeutic use ; Infection - chemically induced ; Infection - microbiology ; Lupus Nephritis - drug therapy ; Lupus Nephritis - physiopathology ; Male ; Middle Aged ; Mycophenolic Acid - adverse effects ; Mycophenolic Acid - analogs & derivatives ; Mycophenolic Acid - therapeutic use ; Original Report: Patient-Oriented, Translational Research ; Recurrence ; Retrospective Studies ; Spain ; Young Adult</subject><ispartof>American journal of nephrology, 2014-01, Vol.40 (2), p.105-112</ispartof><rights>2014 S. Karger AG, Basel</rights><rights>Copyright (c) 2014 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c334t-70818660eabd0a4759dd2358a738f3a61118b0e4f66a0a5e6e79dfefa3b5f5333</citedby><cites>FETCH-LOGICAL-c334t-70818660eabd0a4759dd2358a738f3a61118b0e4f66a0a5e6e79dfefa3b5f5333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25096639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rivera, Francisco</creatorcontrib><creatorcontrib>Mérida, Evangelina</creatorcontrib><creatorcontrib>Illescas, Maria L.</creatorcontrib><creatorcontrib>López-Rubio, E.</creatorcontrib><creatorcontrib>Frutos, Miguel A.</creatorcontrib><creatorcontrib>García-Frías, Patricia</creatorcontrib><creatorcontrib>Ramos, Carmela</creatorcontrib><creatorcontrib>Sierra, María</creatorcontrib><creatorcontrib>Baltar, José</creatorcontrib><creatorcontrib>Lucas, Jesús</creatorcontrib><creatorcontrib>Oliet, Aniana</creatorcontrib><creatorcontrib>Vigil, Ana</creatorcontrib><creatorcontrib>Fernández-Juárez, Gema</creatorcontrib><creatorcontrib>Segarra, Alfons</creatorcontrib><creatorcontrib>Praga, Manuel</creatorcontrib><creatorcontrib>Glomerular Spanish Glomerular Study Group (GLOSEN)</creatorcontrib><creatorcontrib>on behalf for Glomerular Spanish Glomerular Study Group (GLOSEN)</creatorcontrib><title>Mycophenolate in Refractory and Relapsing Lupus Nephritis</title><title>American journal of nephrology</title><addtitle>Am J Nephrol</addtitle><description>Background: Mycophenolate (MF) is effective as induction and maintenance treatment in patients with lupus nephritis (LN). This study evaluates the efficacy and safety of MF in patients with refractory and relapsing LN. Methods: Data were retrospectively obtained for 85 patients (35 refractory and 50 relapsing) from 11 nephrology departments in Spain. The primary endpoints were the incidence and cumulative number of renal responses and relapses and their relationship with baseline clinical and analytical data. The secondary endpoint was the appearance of side effects. Results: The main clinical and analytical variables were similar both in refractory and relapsing LN. Most of the patients had received cyclophosphamide, and all of them switched to MF. 74 patients (87%) achieved a response (69% partial, 31% complete). Age at starting MF, gender, pathological classification, body mass index, blood pressure, baseline renal function, and proteinuria were not associated with achieving response. After stopping MF, 3 of 19 patients (15.7%) relapsed, all at 6 months of follow-up. No differences were found between clinical and analytical variables and number of relapses. Side effects were unremarkable, except for 1 patient, who died of thrombocytopenia and ovarian hemorrhage. Conclusions: Switching to MF from other immunosuppressive treatments is effective and safe in refractory and relapsing LN.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Cyclophosphamide - therapeutic use</subject><subject>Diarrhea - chemically induced</subject><subject>Drug Substitution</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Infection - chemically induced</subject><subject>Infection - microbiology</subject><subject>Lupus Nephritis - drug therapy</subject><subject>Lupus Nephritis - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mycophenolic Acid - adverse effects</subject><subject>Mycophenolic Acid - analogs & derivatives</subject><subject>Mycophenolic Acid - therapeutic use</subject><subject>Original Report: Patient-Oriented, Translational Research</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Spain</subject><subject>Young Adult</subject><issn>0250-8095</issn><issn>1421-9670</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpd0E1PwzAMBuAIgdgYHLgjVIkLHApOsiTNEU18SQMkBOfKbZ2t0LUlaQ_79xRt7MDJsvXYsl7GTjlcc67sDQBIrYTSe2zMp4LHVhvYZ2MQCuIErBqxoxA-AbhIwByy0TC3Wks7ZvZ5nTftkuqmwo6iso7eyHnMu8avI6yLoa2wDWW9iOZ924fohdqlL7syHLMDh1Wgk22dsI_7u_fZYzx_fXia3c7jXMppFxtIeKI1EGYF4NQoWxRCqgSNTJxEzTlPMqCp0xoBFWkytnDkUGbKKSnlhF1u7ra--e4pdOmqDDlVFdbU9CHlSisFUhg90It_9LPpfT18l3ItBOdWGTuoq43KfROCJ5e2vlyhX6cc0t88012egz3fXuyzFRU7-RfgAM424Av9gvwObPd_ALnPds0</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Rivera, Francisco</creator><creator>Mérida, Evangelina</creator><creator>Illescas, Maria L.</creator><creator>López-Rubio, E.</creator><creator>Frutos, Miguel A.</creator><creator>García-Frías, Patricia</creator><creator>Ramos, Carmela</creator><creator>Sierra, María</creator><creator>Baltar, José</creator><creator>Lucas, Jesús</creator><creator>Oliet, Aniana</creator><creator>Vigil, Ana</creator><creator>Fernández-Juárez, Gema</creator><creator>Segarra, Alfons</creator><creator>Praga, Manuel</creator><general>S. 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therapeutic use</topic><topic>Diarrhea - chemically induced</topic><topic>Drug Substitution</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Infection - chemically induced</topic><topic>Infection - microbiology</topic><topic>Lupus Nephritis - drug therapy</topic><topic>Lupus Nephritis - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mycophenolic Acid - adverse effects</topic><topic>Mycophenolic Acid - analogs & derivatives</topic><topic>Mycophenolic Acid - therapeutic use</topic><topic>Original Report: Patient-Oriented, Translational Research</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Spain</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rivera, Francisco</creatorcontrib><creatorcontrib>Mérida, Evangelina</creatorcontrib><creatorcontrib>Illescas, Maria L.</creatorcontrib><creatorcontrib>López-Rubio, E.</creatorcontrib><creatorcontrib>Frutos, Miguel A.</creatorcontrib><creatorcontrib>García-Frías, Patricia</creatorcontrib><creatorcontrib>Ramos, Carmela</creatorcontrib><creatorcontrib>Sierra, María</creatorcontrib><creatorcontrib>Baltar, José</creatorcontrib><creatorcontrib>Lucas, Jesús</creatorcontrib><creatorcontrib>Oliet, Aniana</creatorcontrib><creatorcontrib>Vigil, Ana</creatorcontrib><creatorcontrib>Fernández-Juárez, Gema</creatorcontrib><creatorcontrib>Segarra, Alfons</creatorcontrib><creatorcontrib>Praga, Manuel</creatorcontrib><creatorcontrib>Glomerular Spanish Glomerular Study Group (GLOSEN)</creatorcontrib><creatorcontrib>on behalf for Glomerular Spanish Glomerular Study Group (GLOSEN)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rivera, Francisco</au><au>Mérida, Evangelina</au><au>Illescas, Maria L.</au><au>López-Rubio, E.</au><au>Frutos, Miguel A.</au><au>García-Frías, Patricia</au><au>Ramos, Carmela</au><au>Sierra, María</au><au>Baltar, José</au><au>Lucas, Jesús</au><au>Oliet, Aniana</au><au>Vigil, Ana</au><au>Fernández-Juárez, Gema</au><au>Segarra, Alfons</au><au>Praga, Manuel</au><aucorp>Glomerular Spanish Glomerular Study Group (GLOSEN)</aucorp><aucorp>on behalf for Glomerular Spanish Glomerular Study Group (GLOSEN)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mycophenolate in Refractory and Relapsing Lupus Nephritis</atitle><jtitle>American journal of nephrology</jtitle><addtitle>Am J Nephrol</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>40</volume><issue>2</issue><spage>105</spage><epage>112</epage><pages>105-112</pages><issn>0250-8095</issn><eissn>1421-9670</eissn><coden>AJNED9</coden><abstract>Background: Mycophenolate (MF) is effective as induction and maintenance treatment in patients with lupus nephritis (LN). This study evaluates the efficacy and safety of MF in patients with refractory and relapsing LN. Methods: Data were retrospectively obtained for 85 patients (35 refractory and 50 relapsing) from 11 nephrology departments in Spain. The primary endpoints were the incidence and cumulative number of renal responses and relapses and their relationship with baseline clinical and analytical data. The secondary endpoint was the appearance of side effects. Results: The main clinical and analytical variables were similar both in refractory and relapsing LN. Most of the patients had received cyclophosphamide, and all of them switched to MF. 74 patients (87%) achieved a response (69% partial, 31% complete). Age at starting MF, gender, pathological classification, body mass index, blood pressure, baseline renal function, and proteinuria were not associated with achieving response. After stopping MF, 3 of 19 patients (15.7%) relapsed, all at 6 months of follow-up. No differences were found between clinical and analytical variables and number of relapses. Side effects were unremarkable, except for 1 patient, who died of thrombocytopenia and ovarian hemorrhage. Conclusions: Switching to MF from other immunosuppressive treatments is effective and safe in refractory and relapsing LN.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>25096639</pmid><doi>10.1159/000365256</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Cyclophosphamide - therapeutic use Diarrhea - chemically induced Drug Substitution Female Follow-Up Studies Glomerular Filtration Rate Humans Immunosuppressive Agents - adverse effects Immunosuppressive Agents - therapeutic use Infection - chemically induced Infection - microbiology Lupus Nephritis - drug therapy Lupus Nephritis - physiopathology Male Middle Aged Mycophenolic Acid - adverse effects Mycophenolic Acid - analogs & derivatives Mycophenolic Acid - therapeutic use Original Report: Patient-Oriented, Translational Research Recurrence Retrospective Studies Spain Young Adult |
| title | Mycophenolate in Refractory and Relapsing Lupus Nephritis |
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