Comparison between mycophenolate mofetil and cyclophosphamide pulse therapy in induction treatment of active lupus nephritis

Objective:To compare the efficacy of mycophenolate mofetil (MMF) and cyclophosphamide (CTX) pulse therapy in induction treatment of active lupus nephritis (LN). Methods:Twenty seven LN patients were included. Twelve patients were given MMF at a dose of 1.0 1.5 g/d orally(MMF group). The other 15 patients matched with age, sex and severity of renal damage were given CTX (0.75 1.0 g/m 2 body surface area) monthly for 6 months(CTX group).Both groups were supplemented with oral prednisone. The renal biopsy, blood and urinary routine, hepatic and renal function, 24 h urinary protein excretion, creatinine clearance(Ccr), anti dsDNA antibody titer, antinuclear antibody, serum complement C 3, immunoglobulin G and associated adverse effect were observed before and after treatment in both groups. Results:The SLE DAI, proteinuria, hematuria, anti dsDNA antibody titer and lower serum complement C 3 level were significantly improved in both groups after treatment ( P 0.05). Urinary protein excretion and anti dsDNA antibody titer in MMF group were lower than that of CTX group after treatment( P 0.05). Ccr and anemia were improved obviously in MMF group ( P 0.05), but changed slightly in CTX group( P 0.05).Nine patients in MMF group and 2 in CTX group had repeat renal biopsy. The active index and renal immune complex deposition decreased dramatically after given MMF, but the chronic index had no significant difference after treatment.There was no obvious improvement in CTX group.The incidence of complications was slighter in MMF group. Conclusion:MMF is more effective than CTX pulse therapy in the induction treatment of active LN, and with lower adverse effect.