Should mycophenolate mofetil replace cyclophosphamide as first-line therapy for severe lupus nephritis
Kidney International, 05/31/2012
Hogan J et al. – Mycophenolate mofetil should be considered first–line induction and maintenance treatment therapy for severe lupus nephritis, although cyclphosphamide may have a place under specific clinical and economic circumstances.
- Available treatments for severe (class III, IV, and V) lupus nephritis (LN) have expanded greatly over the last 40 years.
- In the 1970s and 1980s, cyclphosphamide (CYC), in combination with glucocorticoids, gained favor as induction and maintenance therapy for severe LN.
- However, the adverse event profile of CYC led to the search for other medications for severe LN.
- Beginning in the late 1990s, mycophenolate mofetil (MMF) was introduced as induction and maintenance therapy for severe LN.
- This review discusses the clinical trial results, pharmacology, cost–effectiveness, and adverse effect profiles of CYC compared to MMF for induction and maintenance therapy for severe LN.