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Original Report: Patient-Oriented, Translational Research
Am J Nephrol 2012;35:424–433
DOI: 10.1159/000337916
Mycophenolate as Induction
Therapy in Lupus Nephritis with Renal
Function Impairment
F. Rivera
a
X. Fulladosa
b
R. Poveda
b
M.A. Frutos
c
P. García-Frías
c
J. Ara
d
L. Illescas
e
E. López-Rubio
e
E. Mérida
f
A. Carreño
a
J. Ballarín
g
G. Fernández-Juárez
h
J. Baltar
i
C. Ramos
j
S. Pons
j
A. Oliet
k
A. Vigil
k
M. Praga
f
A. Segarra
l
Spanish Group for the Study of Glomerular Disease
(GLOSEN)
a
Hospital General de Ciudad Real, Ciudad Real,
b
Hospital Universitari de Bellvitge, Bellvitge,
c
Hospital Universitario
Carlos Haya, Malaga,
d
Hospital Universitari Germans Trias i Pujol, Badalona,
e
Hospital General Universitario de
Albacete, Albacete,
f
Hospital Universitario 12 de Octubre, Madrid,
g
Fundació Puigvert, Barcelona,
h
Fundación
Hospital Alcorcón, Alcorcón,
i
Hospital Universitario Central de Asturias, Oviedo,
j
Hospital Clinic Universitari de
Valencia, Valencia,
k
Hospital Severo Ochoa, Madrid, y
l
Hospital Vall d’Hebron, Vall d’Hebron, España
of patients who achieved any response and its relationship
with initial eGFR. The secondary outcome measures were the
percentage of patients who achieved a complete response
(CR) or partial response (PR) and the appearance of relapses
during treatment and side effects. Results: At initiation of
MF treatment, there were no differences in the main param-
eters between group 1 (n = 63; eGFR 87 8 23 ml/min/
1.73 m
2
) and group 2 (n = 27; eGFR 44 8 12 ml/min/1.73 m
2
).
Exposure to prednisone and MF was similar. The percentag-
es of patients who achieved a response in groups 1 and 2
were, respectively, 69.2 and 43.8% at 6 months and 81.3 and
73.7% at 12 months. CR was more frequent in group 1, where-
as PR was similar in both groups. Four patients relapsed and
side effects were unremarkable. Conclusions: MF is effective
and safe as induction therapy for LN, and response is even
achieved in patients with baseline renal impairment.
Copyright © 2012 S. Karger AG, Basel
Key Words
Lupus nephritis Systemic lupus erythematous
Mycophenolate Renal failure
Abstract
Background: Mycophenolate (MF) is effective as induction
therapy for lupus nephritis (LN) in patients with normal renal
function; however, little is known about its role in patients
with impaired renal failure. The purpose of this study was to
evaluate the response to MF in LN and its association with
baseline renal function. Methods: Data were obtained for
90 patients from 12 Spanish renal units who were receiving
MF as induction therapy for LN. Patients were classified into
2 groups: group 1 (estimated glomerular filtration rate
[eGFR] 660 ml/min/1.73 m
2
) and group 2 (eGFR !60 ml/min/
1.73 m
2
). The primary outcome measure was the percentage
Received: January 23, 2012
Accepted: March 8, 2012
Published online: April 20, 2012
Nephrolo gy
American Journal of
Dr. Francisco Rivera
Sección de Nefrología
Hospital General de Ciudad Real
ES–13004 Ciudad Real (Spain)
Tel. +34 92 627 8000, E-Mail friverahdez @ senefro.org
© 2012 S. Karger AG, Basel
0250–8095/12/0355–0424$38.00/0
Accessible online at:
www.karger.com/ajn