Document Detail


Prospective controlled study on mycophenolate mofetil and prednisolone in the treatment of membranous nephropathy with nephrotic syndrome.
MedLine Citation:
PMID:  17995584     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Retrospective and anecdotal data suggest that mycophenolate mofetil (MMF) might be effective when given as rescue therapy for membranous nephropathy (MN). Prospective controlled data on MMF and prednisolone as primary therapy are lacking.
METHODS: A prospective, randomized, controlled, open-label study was performed to investigate the efficacy and tolerability of MMF and prednisolone as primary treatment in MN with nephrotic syndrome. MMF and prednisolone given for 6 months was compared against a modified Ponticelli regimen in 20 patients, with follow up of 15 months.
RESULTS: MMF with prednisolone and the comparative immunosuppressive regimen showed similar efficacy in proteinuria reduction, despite a lower cumulative prednisolone dose in the MMF group (3.80 +/- 0.28 vs 9.93 +/- 0.25 g, P < 0.001). Remission (composite of 'complete' and 'partial') rates were 63.6% and 66.7% in the MMF group and control group, respectively (P = 1.000). Serum creatinine and creatinine clearance remained stable during follow up. Cumulative relapse rate was 23.1% at 2 years. Chlorambucil resulted in more leucopenia compared with MMF.
CONCLUSION: Data from this pilot study indicate that more than 60% of patients with MN and nephrotic syndrome respond to combined MMF and prednisolone treatment, and suggest potential benefits of MMF as being steroid-sparing and having less adverse effects compared with other commonly used cytotoxic agents.
Authors:
Tak Mao Chan; Ai Wu Lin; Sydney Cw Tang; Jia Qi Qian; Man Fai Lam; Yiu Wing Ho; Kai Chung Tse; Kwok Wah Chan; Kar Neng Lai; Colin So Tang
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  12     ISSN:  1320-5358     ISO Abbreviation:  Nephrology (Carlton)     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-12     Completed Date:  2008-05-30     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  576-81     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong. dtmchan@hkucc.hku.hk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Female
Glomerulonephritis, Membranous / drug therapy*
Humans
Male
Middle Aged
Mycophenolic Acid / adverse effects,  analogs & derivatives*,  therapeutic use
Nephrotic Syndrome / drug therapy*
Prednisolone / adverse effects,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
24280-93-1/Mycophenolic Acid; 50-24-8/Prednisolone; 9242ECW6R0/mycophenolate mofetil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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