Low dose mycophenolate mofetil prevented a clinical relapse in patients with lupus nephritis

Purpose To determine the efficacy and safety of low dose mycophenolate mofetil(MMF) and prednisone in the induction and maintenance treatment of severe lupus nephritis. Methods Thirteen patients(3 males and 10 females) with lupus nephritis(3 in class Ⅲ,8 in class Ⅳ,2 in class Ⅴ+Ⅳ) were treated with MMF and prednisone daily for 48-92 weeks(mean 69.2±18.8 weeks).Proteinuria,serum albumin,liver function,serological activity and complement were monitored monthly for the occurrence of a clinical relapse.The starting dose of MMF ranged from 1.0 g/d to 1.5 g/d.At the same time,the standard dose prednisone was given.During maintenance therapy,MMF dose was(0.6±0.3) g/d,prednisone dose was(10.9±5.8) mg/d. Results Eleven of 13 patients were nephrotic syndrome.Before the treatment,baseline activity index was 7.7±(1.7) and chronicity index was 1.3±0.9.Complete remission was achieved in 6 patients and partial remission was achieved in 6 patients at 24 weeks.During maintenance therapy,no clinical relapse was occurred,and improvements in haemoglobin,serum creatinine,serum albumin were maintained.Side effects were minimal. Conclusions Low dose MMF in combination with prednisone showed strong efficacy in controlling the clinical relapse of lupus nephritis and nephrotic syndrome.And it was well tolerated.