Mycophenolate mofetil therapy versus cyclophosphamide treatment in patients with severe IgA nephropathy

Objective:To compare the clinical efficacy of mycophenolate mofetil(MMF) with that of cyclophosphamide(CTX) in the treatment of severe IgA nephropathy.Methods:Forty-one patients with severe IgA nephropathy were enrolled into this study and were divided into MMF and CTX groups.MMF group included 21 cases that were treated with MMF at a dosage of 1.5 g/d.CTX group enrolled 20 cases that were given intravenous drip 0.4 g/2d and the total dosage was less than 8 g.The patients were followed up for more than 12 months.The clinical efficacy and side effects were compared between the two groups.Results:① Clinical remission rate in the 12th month was 90.4% in MMF therapy and it was 60.0%in CTX group.The difference of the clinical remission rate between the two groups was significant(P0.05).② The concentration of proteinuria in 24 h in MMF group was lower than that in CTX group(P0.05).③ After the therapy,the level of blood-lipid decreased obviously in MMF group,but it did not changed in CTX group(P0.05).④ The side effect in both groups were 9.5%(MMF group) vs 40%(CTX group)(P0.05).Conclusion:The combination therapy of MMF and steroid was more effective than CTX intravenous drip in treatment of severe IgA nephropathy and has fewer side effects.