Treatment of lupus nephritis and primary glomerulonephritis with enteric-coated mycophenolate sodium

• Published in: Clinical nephrology Vol. 69; no. 2; p. 90
• Main Authors: Kitiyakara, C, Ophascharoensuk, V, Changsirikulchai, S, Ingsathit, A, Tankee, P, Sangpanich, A, Sumethkul, V
• Format: Journal Article
• Language: English
• Published: Germany 01.02.2008
• Subjects: Administration, Oral; Adolescent; Adult; Biopsy; Creatinine - blood; Creatinine - urine; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Glomerular Filtration Rate; Glomerulonephritis - drug therapy; Glomerulonephritis - metabolism; Glomerulonephritis - pathology; Humans; Immunosuppressive Agents - administration & dosage; Lupus Nephritis - drug therapy; Lupus Nephritis - metabolism; Lupus Nephritis - pathology; Male; Middle Aged; Mycophenolic Acid - administration & dosage; Mycophenolic Acid - analogs & derivatives; Prodrugs; Remission Induction; Retrospective Studies; Tablets, Enteric-Coated - administration & dosage; Treatment Outcome
• ISSN: 0301-0430
• DOI: 10.5414/CNP69090

Mycophenolate mofetil is an effective therapy for lupus nephritis (LN) and other glomerulonephritis (GN). However, gastrointestinal (GI) complications can limit its use. Enteric-coated mycophenolate sodium (EC-MPS) has been designed to reduce GI adverse events, but it has not been fully investigated in the treatment of GN. Patients with LN and primary GN who had received EC-MPS were studied for effects on renal function. 30 subjects (17 LN, 13 primary GN) were studied. EC-MPS decreased proteinuria in both LN and GN. In LN, 16 patients had EC-MPS as induction therapy. Of these, 8 patients achieved complete remission (CR), 4 had partial remission (PR) and 1 improved renal function. In primary GN, CR was achieved in 4 out of 5 with minimal change disease, but only 1 did not relapse. PR was achieved in 1 of 4 patients with membranous glomerulopathy, 2 out of 2 patients with focal segmental glomerulosclerosis and 1 out of 2 patients with IgA nephropathy. Infections, anemia and alopecia were observed, but no patient had GI side effects. EC-MPS is effective in LN, but not as effective in primary GN. The risk of GI side effects appears to be low, but other side effects can still occur.