72 weeks follow-up study of the effects of mycophenolate mofetil on IgA nephropathy

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72 weeks follow-up study of the effects of mycophenolate mofetil on IgA nephropathy Am Soc Nephrol Ann Mtg -- San Francisco J Am Soc Nephrol (Sep) 12:66A 2001

Mycophenolate Mofetil (MMF) is a new immunosuppressive agent widely used in transplant recipients. With its specific action against activated B and T cells, it may reduce inflammatory infiltration and may be a valuable way to prevent the progression of IgAN. In order to investigate the effects of MMF on IgAN, we compared MMF against prednisone with 36 cases last year, and found that MMF has short-term efficacy in IgAN, especially in decreasing proteinuria and blood lipid. In the followed 48 weeks, we had continued observing 62 IgAN patients (53 male, 9 female). Age at onset was 9-54-year-old. Before treatment, proteinuria was all more than 2.0g/24hr. Renal biopsy showed the IV grade(Lee's). Patients were divided into two groups at random. One group was given MMF (0.5g or 0.75g twice daily), the other prednisone (30mg to 40mg daily). 15 cases of each group received treatment over 72 weeks. After 12 and 24 weeks of treatment, the proteinuria of both groups showed a marked decrease (p<0.01). The decrease in proteinuria of MMF group was more than that of prednisone group after 24 weeks. After 72 weeks of treatment, the proteinuria of the MMF group continued decreasing, while no change in prednisone group. After 12 weeks of therapy, the serum albumin of two groups showed an obvious increase (p<0.05). After 72 weeks of treatment, serum albumin of MMF was markedly increased and higher than those of both 12 weeks (p<0.05) and 24 weeks (p<0.05), and was higher than that of prednisone group which was no change. Serum triglyceride and cholesterol of MMF group both declined after treatment (p<0.05). However, the lipid of prednisone group did not change. After 72 weeks, the serum creatinine of predisone group was increased, and higher than that of MMF group (p<0.05). Gastrointestinal side effects appeared in three patients. Our experience supported that MMF has efficacy in IgAN and its comprehensive effect is better than that of prednisone in decreasing proteinuria, blood lipid and in protecting the renal function.