Mycophenolate mofetil treatment for primary glomerular diseases

Choi, Michael; Eustace, Joseph A.; Gimenez, Luis F.; Atta, Mohamed G.; Scheel, Paul J.; Sothinathan, Renuka; Briggs, William A.

doi:10.1046/j.1523-1755.2002.00214.x

Cited by 192 publications

(135 citation statements)

References 30 publications

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“…16 A number of therapeutic measures using glucocorticoids, 9,10 alkylating agents, 9,10 calcineurin inhibitors, 11,12,29-31 mycophenolate mofetil (MMF), 13,32 and rituximab 8,33 have been published. Among them, the 6-month course of alternating months of glucocorticoids and cyclophosphamide described by Ponticelli et al 10 seems to be a first-line regimen because it offers higher remission rates and long-term benefits, including increased quality of life.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria

Matsumoto¹,

Shimada²,

Nojima³

et al. 2013

Renal Failure

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Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria, Renal Failure, 35:7,[936][937][938][939][940][941] Background: Idiopathic membranous nephropathy (IMN) patients with persistent high-grade proteinuria are at the highest risk for developing end-stage renal failure. We previously reported the effects of treatment with mizoribine followed by low-dose prednisone treatment in 4 IMN patients. The purpose of the present study was to further assess the effects of this combined treatment in a larger study group. Method: Thirteen patients with IMN and nephroticrange proteinuria received combined treatment. Mizoribine was initiated at a dose of 150 mg/ day, and 2-3 months later, 20 mg/day prednisone was added to the mizoribine regimen. The dosage of prednisone and/or mizoribine was tapered according to the urinary proteinto-creatinine ratio (P/C). We evaluated patient responses for up to 12 months after the initiation of combination therapy. Results: Before treatment, patient urinary P/C ranged from 3.7 to 15.9 g/g. Although these values did not decrease during mizoribine monotherapy, all patients showed dramatic P/C decreases over the course of combination therapy. At 3, 6, and 12 months after combination therapy, 15%, 31%, and 62% of patients attained complete remission, respectively, and all patients were in partial or complete remission 6 months after combination therapy. No notable side effects were observed. Conclusion: The addition of prednisone after mizoribine monotherapy can be beneficial for all IMN patients with nephrotic-range proteinuria syndrome. The risks associated with immunotherapy can be decreased by initially prescribing mizoribine alone, which might act as a base for establishing therapy, followed by low-dose prednisone treatment.

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Section: Discussionmentioning

confidence: 99%

Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria

Matsumoto¹,

Shimada²,

Nojima³

et al. 2013

Renal Failure

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“…In adults, mycophenolate mofetil has shown efficacy in case reports and small case series, 18,[60][61][62][63][64][65][66][67][68] with remission rates of 60%-80% in this limited experience.…”

Section: Mycophenolate Mofetilmentioning

confidence: 99%

The Treatment of Minimal Change Disease in Adults

Hogan

Radhakrishnan

2013

Journal of the American Society of Nephrology

122

120

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Minimal change disease (MCD) is the etiology of 10%-25% of cases of nephrotic syndrome in adults. The mainstay of treatment for adult MCD, oral gucocorticoids, is based on two randomized controlled trials and extensive observational data in adults, and this treatment leads to remission in over 80% of cases. Relapses are common, and some patients become steroid-resistant (SR), steroid-dependent (SD), or frequently relapsing (FR). The data guiding the treatment of these patients are limited. Here, we review MCD in adults with particular focus on the evidence for immunosuppressive therapy in these patients.

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“…After screening the remaining 37 full-text articles, 15 articles were excluded. One was excluded because 18 different intervention strategies were used and no individual data for MMF was reported, 31 eight were excluded as they did not report at least two pre-specified outcomes, [32][33][34][35][36][37][38][39] two were excluded because no primary FSGS patients were recruited, 40,41 and the remaining four excluded articles were reviews. 1,5,42,43 Finally, two ongoing studies were identified but results are not yet available.…”

Section: Description Of Studies and Risk Of Bias Assessmentmentioning

confidence: 99%

“…[45][46][47] The three studies together had 18 biopsies confirmed primary FSGS patients and the follow-up ranged from 8 to 56 months. All of the three studies recruited patients who were dependent on or resistant to current routine therapies.…”

Section: Description Of Studies and Risk Of Bias Assessmentmentioning

confidence: 99%

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Mycophenolate mofetil for primary focal segmental glomerulosclerosis: systematic review

Lau

et al. 2013

Renal Failure

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Mycophenolate mofetil treatment for primary glomerular diseases

Abstract: Empirical MMF therapy in the majority of patients with primary glomerulopathies was well tolerated and achieved the goals of steroid withdrawal, improvement of nephrotic syndrome, and stabilization of renal function.

Cited by 192 publications

References 30 publications

Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria

Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria

The Treatment of Minimal Change Disease in Adults

Mycophenolate mofetil for primary focal segmental glomerulosclerosis: systematic review

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