Mycophenolate mofetil versus intravenous cyclophosphamide for induction treatment of proliferative lupus nephritis in a Japanese population: a retrospective study

Abstract

MMF may be used as an alternative to IVC for inducing renal remission of LN in Japanese patients.

Systemic Lupus Erythematosus: Targeted Literature Review of the Epidemiology, Current Treatment, and Disease Burden in the Asia Pacific Region

“…A total of 70 unique publications (3,4,10,11, comprised of 27 clinical studies, 16 epidemiologic studies, and 27 studies reporting economic and humanistic burden and unmet need met the inclusion criteria (see Supplementary Appendix C, available at http:// onlinelibrary.wiley.com/doi/10.1002/acr.24431/abstract). Most of the studies were conducted in China (n = 14) (11,19,21,23,28,29,38,43,47,54,59,78,79,82), Japan (n = 13) (31,(33)(34)(35)(36)(37)40,58,65,67,74,75,77), and Taiwan (n = 12) (20,22,24,25,45,52,56,60-62, 64,69), followed by Korea (n = 9) (17,26,32,42,44,53,63,72,76), Australia (n = 7) (4,18,39,49,50,57,…”

“…Disease characteristics of patients in included studies. Disease characteristics were reported for SLE patients in studies from Australia (n = 6) (4,18,39,50,57,66), China (n = 15) (11,19,21,23,28,29,38,43,47,54,59,78,79,82), Hong Kong (n = 6) (10,30,46,71,80,81), Japan (n = 13) (31,(33)(34)(35)(36)(37)40,58,65,67,74,75,77), Korea (n = 7) (17,26,41,42,44,63,72), Singapore (n = 4) (27,48,55,70), and Taiwan (n = 10) (20,22,24,25,45,52,…”

“…Of 27 clinical studies identified by this TLR, 20 reported treatment outcomes of existing therapies in the APAC region (see Supplementary Appendix C, available at http://onlinelibrary.wiley.com/doi/10.1002/acr.24431/abstract). A range of study designs were reported, including a pharmacokinetics/pharmacodynamics study, phase III clinical trials, and prospective and retrospective observational studies that assessed a variety of approved and experimental drug treatments (including cyclophosphamide [31,33], belimumab [38,41], rituximab [17,18,27,36,39], epratuzumab [37], tabalumab [35], azathioprine [19,21], hydroxychloroquine [22,24,40], and glucocorticoids [10,20,26]). However, only hydroxychloroquine, cyclophosphamide, azathioprine, and mycophenolate mofetil (MMF) are routinely used in the APAC region due to the lack of approval for other medicines in this region (10,24).…”

“…However, only hydroxychloroquine, cyclophosphamide, azathioprine, and mycophenolate mofetil (MMF) are routinely used in the APAC region due to the lack of approval for other medicines in this region (10,24). Among drugs targeting the immune system, cyclophosphamide demonstrated similar efficacy to MMF for induction therapy for active lupus nephritis and provided a synergistic effect with tacrolimus to promote remission (31,33). However, cyclophosphamide is associated with significantly more adverse events (AEs) compared with MMF, including anemia and thrombocytopenia.…”

Treatment Outcomes of Proliferative vs. Non-proliferative Adult Lupus Nephritis: A 10-Year Follow-Up

“…In contrast, El-Shafey et al's data suggest MMF as an alternative treatment to induction by pulse cyclophosphamide [24]. However, Onishi et al deferred the MMF superiority to pulse cyclophosphamide induction [25]. Kallenberg demonstrated that both the Euro-Lupus protocol and MMF with corticosteroids might be considered for remission induction in patients with proliferative LN [26].…”