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Mycophenolate mofetil in the treatment of systemic lupus erythematosus
Current Opinion in Rheumatology, 07/05/2011
Clinical Article
Dall’Era M et al. – Favorable efficacy and safety results of several clinical trials conducted over the past 10 years have led to the adoption of MMF for the treatment of lupus nephritis and nonrenal lupus. Future research will be important to more fully understand the best dosing regimen of MMF for induction versus maintenance treatment, total duration of treatment, and the utility of therapeutic monitoring of MMF levels.
Methods- This review will discuss key studies that have contributed to understanding of efficacy and safety of MMF in treatment of SLE
- The Aspreva Lupus Management Study (ALMS) firmly established that MMF is equivalent to intravenous pulse cyclophosphamide (IVC) for the induction treatment of lupus nephritis
- MMF shown to be superior to azathioprine in decreasing incidence of treatment failure during maintenance therapy
- A posthoc analysis of the induction phase of ALMS suggested that MMF also improved nonrenal manifestations of SLE
- In contrast to ALMS maintenance results, a European trial concluded that MMF and azathioprine were equivalent in ability to prevent renal flare after induction treatment with low-dose IVC
