Background: Mycophenolate mofetil (MMF) has long been used to manage lupus nephritis. Despite research on its
long-term efficacy, it is still warranted to conduct further investigation regarding its indications, safety and outcome.
This study was intended to evaluate our proposed protocol in maintenance therapy with MMF.
Twenty-four lupus nephritis patients were registered prior to their receiving 3–6 month induction therapy with
monthly iv pulses of cyclophosphamide (CYC), followed by 24 month maintenance therapy using MMF and steroid.
We defined end points as achievement of complete and partial remission, relapse, refractory to therapy as well as
end stage renal disease (ESRD) and death. Friedman and repeated measurement tests were used to assess the
effect of treatment on parameters over time.
Complete renal remission was achieved in 79.16% until the end of the last follow up with an average period of
12.45 ± 7.37 months since treatment commenced. Significant statistical differences were seen regarding proteinuria,
hematuria, leukocyturia, plasma creatinine, C3, C4 before and after therapy (P < 0.05): plasma creatinine and
proteinurea falling from 0.96 ± 0.65 to 0.75 ± 0.19 mg/dl (P < 0.14) and from 1.64 ± 1.12 to 0.27 ± 0.60 gr/24 h
(P < 0.001). By the end of 24-month, 95.8% of patients had been in remission. Four episodes of relapse ended in
remission followed by retreatment. No life-threatening side effects were observed in 66.6% of patients with fourteen
cases of infection (58.3%). None of them developed ESRD.
Maintenance therapy with MMF was shown to yield favorable outcome with minimal complications, in treating
lupus nephritis (IRCT2012071710313N1).
Keywords: Lupus nephritis; Mycophenolate mofetil; Glomerulonephritis
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