Skip to main content

Advertisement

Use of mycophenolate mofetil (MMF) in lupus nephritis (LN) in children

Article metrics

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease; 86% of children with SLE have renal involvement, that ranges from asymptomatic urinary findings to nephritic syndrome and renal failure. Cyclophosphamide (CYC) and corticosteroids (CCS) has been the standard of care for many years, despite their failure or potential toxicities. Studies have showed good results with MMF in LN. We evaluated, in an observational study, the efficacy of MMF as induction and maintenance therapy in LN in children. Eighteen patients (15 female and 3 male, median age 12,2 ys) were evaluated with biopsy-proven LN, 13/18 received CYC or CCS as induction and then MMF, 5/18 received MMF plus CCS as from start. The following parameters were recorded at baseline and follow-up: serum creatinine, urinary protein excretion in 24 hours, full blood count, complement components (C3–C4), ANA positivity, ENA profile, SLEDAI score and histologic indices of activity and chronicity by Austin and coll. The median treatment time with MMF was 3 years. Our patients showed return in the range of normality of serum creatinine (p < 0,01), urinary protein excretion in 24 hours (p < 0,01), full blood count, complement components (C3–C4) (p < 0,01), ANA positivity (p < 0,01), ENA profile (p < 0,01), SLEDAI score (p < 0,01) and histologic indices of activity and chronicity (p < 0,01). In all patients CCS was suspended in 2 months. We had only 2 patients with adverse effects (1 diarrhoea, 1 viral infection). MMF as induction and manteinance therapy can be efficacy and safe in treatment of LN in children.

References

  1. 1.

    Zhu B, Chen N, Lin Y: Mycophenolate mofetil in induction and maintenance therapy of severe lupus nephritis: a meta-analysis of randomized controlled trials. Nephrol Dial Transplant. 2007, 22 (7): 1933-42. 10.1093/ndt/gfm066.

  2. 2.

    Walsh M, James M, Jayne D: Mycophenolate mofetil for induction therapy of lupus nephritis: a systematic review and meta-analysis. Clin J Am Soc Nephrol. 2007, 2 (5): 968-75. 10.2215/CJN.01200307.

Download references

Author information

Correspondence to R Indaco.

Rights and permissions

Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and Permissions

About this article

Cite this article

Indaco, R., Alessio, M., Caropreso, M. et al. Use of mycophenolate mofetil (MMF) in lupus nephritis (LN) in children. Pediatr Rheumatol 6, P254 (2008) doi:10.1186/1546-0096-6-S1-P254

Download citation

Keywords

  • Systemic Lupus Erythematosus
  • Cyclophosphamide
  • Serum Creatinine
  • Nephritis
  • Maintenance Therapy