Treatment of Lupus Nephritis by Mycophenolate Mofetil

Rabrenović, Violeta; Poskurica, Mileta; Kovačević, Zoran; Nešić, Vladimir; Savin, Marina; Mitić, Branka; Dimković, Nada; Čučković, Čedomir; Vujic, Danica; Pljesa, Steva; Peruničić-Peković, Gordana; Curić, S; Mitić, Igor; Ratković, Marina; Marinković, Jelena; Jovanović, Dragan

doi:10.1159/000316321

Cited by 6 publications

(6 citation statements)

References 66 publications

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“…During the last decade, the results of at least 9 trials have been reported [8,9,11,12,13,14,15,16,17], and several retrospective studies [18,19,20] have focused on the best drug schedule in the maintenance phase of treatment of LN. The results allow us to conclude that short-term induction with intravenous CYC followed by maintenance therapy with MF or AZA was more efficacious than other treatment schedules [11,12,13,15].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies analyze patients with normal renal function [8,13,18,19,20], and only two included cases with elevated serum creatinine and/or decreased eGFR at the initiation of maintenance therapy with MF [9,11]. However, no studies include subanalyses of the effect of baseline renal function on renal relapse and response.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to adverse effects, the most relevant studies conclude that MF is well tolerated [8,9,11,13,18,19,20]. The main adverse effects are gastrointestinal symptoms and infections, which affect between 13 and 60% of patients [8,11,13].…”

Section: Discussionmentioning

confidence: 99%

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Mycophenolate as Maintenance Therapy for Lupus Nephritis with Impaired Renal Function

et al. 2013

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Background: Mycophenolate (MF) is effective as a maintenance therapy after induction therapy in patients with lupus nephritis (LN). However, little is known about its role in patients with impaired renal function. The purpose of this study was to evaluate the efficacy and safety of MF as a maintenance therapy for LN and its association with renal function. Methods: Data were obtained for 56 Spanish patients who were receiving MF as a maintenance therapy for LN. Patients were classified into two groups according to renal function at the initiation of MF treatment: group 1 [estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m²] and group 2 (eGFR <60 ml/min/1.73 m²). The primary endpoints of the study were the rates of renal relapse and responses, and their relationship with baseline renal function. Secondary outcomes were the appearance of side effects during treatment. Results: At initiation of MF treatment, the only differences between the groups were for age, hemoglobin levels, anti-DNA antibody titer, proteinuria, and renal function. In group 1 (n = 38), the eGFR was 98 ± 34 ml/min/1.73 m² and in group 2 (n = 18) the eGFR was 43 ± 14 ml/min/1.73 m². Only 3 cases had an eGFR <30 ml/min/1.73 m². No significant differences were observed in the rate of relapse at 6 months (group 1: 20%; group 2: 23%) or at 12 months (group 1: 25%; group 2: 17%). Response rates were also similar in both groups. Side effects were unremarkable. Conclusions: MF is effective and safe as a maintenance therapy for LN both in patients with normal renal function and in those with renal impairment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mycophenolate as Maintenance Therapy for Lupus Nephritis with Impaired Renal Function

et al. 2013

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“…These findings were consistent with previous studies. 24,26,27 This can be explained by the fact that lupus nephritis is more common in young females.…”

Section: Discussionmentioning

confidence: 99%

Serum complement levels as prognostic marker for monitoring treatment response in lupus nephritis

Khan¹,

Islam²,

Mizan³

et al. 2021

Birdem Med J

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Background: Lupus nephritis (LN) is one of the most common and serious manifestations of systemic lupus erythematosus (SLE) that causes significant morbidity and mortality. Certain biomarkers for LN are sometimes able to assess treatment response in lupus nephritis. This study aimed to compare serum complement levels (C3 and C4) as markers of treatment response of LN and their relation to the LN class in renal biopsy. Methods: This prospective observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2018 to August 2019. Twenty seven patients who were diagnosed with LN after kidney biopsy were included in this study. Serum complement levels (C3 and C4), 24 hours urinary total protein (24-hr UTP) and anti-double-stranded DNA (anti-ds DNA) were measured in all patients at baseline, 3 months and 6 months after treatment initiation. These biomarker values before and after treatment were compared between the proliferative and non-proliferative LN patients. Results: Serum C3 levels were significantly different between patients with proliferative LN (Class III and Class IV) and non-proliferative LN (Class V) at baseline (0.47 ± 0.32 g/l versus 0.89 ± 0.43 g/l, p=0.009) and levels changed significantly 6 months after treatment initiation (p<0.001) and likewise for serum C4 levels (0.10 ± 0.06 g/l versus 0.24 ± 0.26 g/l, p=0.040). The values of 24-hr UTP and anti-ds-DNA were significantly different 6 months after treatment with p value <0.05 in both groups but C3 (p<0.001) and renal Systemic Lupus Erythematosus Disease Activity Index (rSLEDAI) (p<0.001) were only significant in the proliferative group. On the other hand, after 6 months treatment, C4 levels became relatively higher but that was not significant in both groups (p>0.05). Conclusion: After 6 months of treatment, serum C3 and C4 levels increased towards normal in both LN groups. Serum C3 and C4 levels in patients with LN correlate with disease activity. Therefore, serum complement (C3 and C4) levels may be utilized as serological biomarkers for treatment response of LN. Birdem Med J 2021; 11(2): 97-102

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“…Glomerular nephritis is a type of diffuse or focal autoimmune disease characterized by glomerular damage (1). Clinical manifestations include edema, abnormal urine (proteinuria, hematuria), anemia, renal dysfunction and difficult treatment; with disease migration, most patients may develop chronic renal failure, and the prognosis is poor (2).…”

Section: Introductionmentioning

confidence: 99%

Effects of Artesunate prevent nephritis via the Toll-like receptor 4/nuclear factor-κB signaling pathway in rats

Wan

2017

Molecular Medicine Reports

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The active ingredient in Artemisia carvifolia, artemisinin, may alleviate inflammation and toxicity. Artemisinin and its derivatives are first‑line anti‑malarial drugs currently, which have rapid effects on fever caused by malaria parasites with fewer side effects. The present study investigated the effects of Artesunate in a mouse nephritis model. Mice were injected intraperitoneally with 500 µl pristine to induce nephritis, and were treated with 28.8 mg/kg Artesunate. Subsequently, proteinuria, renal function, and tumor necrosis factor (TNF)‑α and interleukin (IL)‑6 levels were assessed to evaluate the effects of Artesunate on nephritis. Western blot analysis was used to measure the protein expression levels of α‑smooth muscle actin (SMA), TLR4, myeloid differentiation primary response gene 88 (MyD88), NF‑κB p65 and transforming growth factor (TGF)‑β1 to investigate the underlying mechanisms of Artesunate on nephritis. The results demonstrated that Artesunate reduced proteinuria and preserved renal function in nephritis mice. Artesunate attenuated TNF‑α and IL‑6 levels, suppressed α‑SMA, TLR4, MyD88, NF‑κB p65 and TGF‑β1 protein expression, and decreased caspase‑3 activity in nephritis mice. These results indicated that the effects of Artesunate may prevent nephritis and inhibit inflammation via the TLR4/NF‑κB signaling pathway in mice. Therefore, Artesunate may be a potential therapeutic agent to prevent nephritis.

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Treatment of Lupus Nephritis by Mycophenolate Mofetil

Cited by 6 publications

References 66 publications

Mycophenolate as Maintenance Therapy for Lupus Nephritis with Impaired Renal Function

Mycophenolate as Maintenance Therapy for Lupus Nephritis with Impaired Renal Function

Serum complement levels as prognostic marker for monitoring treatment response in lupus nephritis

Effects of Artesunate prevent nephritis via the Toll-like receptor 4/nuclear factor-κB signaling pathway in rats

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