Clinical study of mycophenolate mofetil therapy versus intermittent cyclophosphamide pulse treatment in lupus nephritis

Objective To evaluate the therapeutic effect and side-effect between pulse cyclophosphamide (CTX) therapy and mycophenolate mofetil(MMF) in lupus nephritis. Methods A group (CTX group): 30 patients were given intravenous cyclophosphamide (0.5 -0.75 g/m~2) pulse plus oral prednisone. All patients were treated for (18. 65 ±6. 10) (6 -24) months. B group (MMF group): 30 patients were given MMF at a dosage of 1. 0 -1. 5 g/d and oral prednisone. All patients were treated for (21. 89±7. 48) (6-48) months. Patients in two groups were comparable in age, sex distribution, severity of renal damage. Most patients in B group were refractory to cyclophosphamide therapy, and their histories were much longer than those of A group. Results CTX and MMF both reduced proteinuria and hematuria, and improved renal function and immune indexes CTX and MMF were effective on inhibiton of autoantibodies production. The mean therapeutic period of B group was significantly longer than that of A group, but the ontcome of two groups was similar. Liver toxicity and amenorrhea were not observed, while infections(13. 3% ), herpes zoster(6. 7% ), leukopenia(3. 3% ) were found during MMF treatment. And in CTX group, liver toxicity(23. 3% ), amenorrhea(28% ), infections(23. 3% ), herpes zoster( 10% ), leukopenia (10% ) occurred. Conclusion For the treatment of lupus nephritis, the combination of mycophenolate mofetil and prednisone is as effective as the regimen of cyclophosphamide and prednisone but less toxicity.