Comparison of the efficacy and safety of mycophenolate mofetil combined with leflunomide or tacrolimus induction in the treatment of lupus nephritis

SHAO Huijun; RAN Chenyu; WU Yue; LIU Qun; MA Yan; TAO Jinhui

doi:10.16462/j.cnki.zhjbkz.2024.09.018

Volume 28 Issue 9

Sep. 2024

Turn off MathJax

Article Contents

Article Navigation > CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION > 2024 > 28(9): 1112-1116

SHAO Huijun, RAN Chenyu, WU Yue, LIU Qun, MA Yan, TAO Jinhui. Comparison of the efficacy and safety of mycophenolate mofetil combined with leflunomide or tacrolimus induction in the treatment of lupus nephritis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(9): 1112-1116. doi: 10.16462/j.cnki.zhjbkz.2024.09.018

Citation:

SHAO Huijun, RAN Chenyu, WU Yue, LIU Qun, MA Yan, TAO Jinhui. Comparison of the efficacy and safety of mycophenolate mofetil combined with leflunomide or tacrolimus induction in the treatment of lupus nephritis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(9): 1112-1116. doi: 10.16462/j.cnki.zhjbkz.2024.09.018

Citation:

SHAO Huijun, RAN Chenyu, WU Yue, LIU Qun, MA Yan, TAO Jinhui. Comparison of the efficacy and safety of mycophenolate mofetil combined with leflunomide or tacrolimus induction in the treatment of lupus nephritis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(9): 1112-1116. doi: 10.16462/j.cnki.zhjbkz.2024.09.018

PDF( 790 KB)

Comparison of the efficacy and safety of mycophenolate mofetil combined with leflunomide or tacrolimus induction in the treatment of lupus nephritis

doi: 10.16462/j.cnki.zhjbkz.2024.09.018

SHAO Huijun¹,
RAN Chenyu²,
WU Yue¹,
LIU Qun²,
MA Yan¹,
TAO Jinhui^{1, 2
,
,}

1.
Department of Allergy and Clinical Immunity, The First Affiliated Hospital of the University of Science and Technology of China, Hefei 230001, China
2.
School of Clinical Medicine, Wannan Medical College, Wuhu 241002, China

Funds:

Fundamental Research Funds for the Central Universities YD9110002017

More Information

Corresponding author: TAO Jinhui, E-mail: taojinhui@ustc.edu.cn
Received Date: 2024-01-29
Rev Recd Date: 2024-05-16

Available Online: 2024-10-24

Publish Date: 2024-09-10

Abstract

Abstract

Objective To evaluate the efficacy and safety of mycophenolate mofetil (MMF) in combination with either leflunomide (LEF) or tacrolimus (TAC) as induction therapy for lupus nephritis (LN). Methods Patients with refractory LN who did not respond to monotherapy with MMF or cyclophosphamide (CYC) were selected for switching to combination therapy with MMF (1 g/d) plus either LEF (20 mg/d) or TAC (2 mg/d). The remission rates, laboratory parameters, and adverse reactions were compared between the two groups. Results A total of 278 patients with LN were included, and 38 patients (19 in each group) were selected for analysis. The results showed that: (1) In terms of achieving remission in LN, at 3 months, there were 7 cases (36.84%) in the MMF+LEF group and 10 cases (52.63%) in the MMF+TAC group; at 6 months, there were 10 cases (52.63%) in the MMF+LEF group and 14 cases (73.68%) in the MMF+TAC group. However, the differences in remission rates between the two groups at 3 months and 6 months were not statistically significant (all P>0.05). (2) After 6 months of treatment, there were statistically significant differences in complement C3, C4, blood urea nitrogen, albumin, IgA, IgM, and urine total protein/creatinine ratio between the two groups (all P < 0.05). However, there were no statistically significant differences between the two groups at 3 months and 6 months (all P>0.05). (3) There were no significant differences in adverse reactions between the two groups (P>0.05). Conclusions Both the combination of MMF and LEF, as well as the combination of MMF and TAC, significantly improved the condition of LN. There were no significant differences in remission rates and safety between the two combinations.
- Systemic lupus erythematosus,
- Lupus nephritis,
- Mycophenolate mofetil,
- Leflunomide,
- Tacrolimus

FullText(HTML)

References(10)

References

[1]	Durán-Barragán S, McGwin G Jr, Vilá LM, et al. Angiotensin-converting enzyme inhibitors delay the occurrence of renal involvement and are associated with a decreased risk of disease activity in patients with systemic lupus erythematosus: results from LUMINA (LIX): a multiethnic US cohort[J]. Rheumatology, 2008, 47(7): 1093-1096. DOI: 10.1093/rheumatology/ken208.
[2]	黎磊石, 刘志红. 治疗狼疮性肾炎的新型免疫抑制剂及疗法[J]. 肾脏病与透析肾移植杂志, 2007, 16(4): 345-346. DOI: 10.3969/j.issn.1006-298X.2007.04.008. Li LS, Liu ZH. New immunosuppressive agents and therapies for treating lupus nephritis[J]. Chin J Nephrol Dial Transplant, 2007, 16(4): 345-346. DOI: 10.3969/j.issn.1006-298X.2007.04.008.
[3]	Jiang Q, Yang GC, Liu Q, et al. Function and role of regulatory T cells in rheumatoid arthritis[J]. Front Immunol, 2021, 12: 626193. DOI: 10.3389/fimmu.2021.626193.
[4]	Tam LS, Li EK, Wong CK, et al. Safety and efficacy of leflunomide in the treatment of lupus nephritis refractory or intolerant to traditional immunosuppressive therapy: an open label trial[J]. Ann Rheum Dis, 2006, 65(3): 417-418. DOI: 10.1136/ard.2005.044248.
[5]	Aringer M, Costenbader K, Daikh D, et al. 2019 European league against rheumatism/american college of rheumatology classification criteria for systemic lupus erythematosus[J]. Ann Rheum Dis, 2019, 78(9): 1151-1159. DOI: 10.1136/annrheumdis-2018-214819.
[6]	张辉, 杨念生, 鲁静, 等. 狼疮肾炎诊疗规范[J]. 中华内科杂志, 2021, 60(9): 784-790. DOI: 10.3760/cma.j.cn112138-20210609-00410. Zhang H, Yang NS, Lu J, et al. Diagnostic and treatment guidelines for lupus nephritis[J]. Chin J Intern Med, 2021, 60(9): 784-790. DOI: 10.3760/cma.j.cn112138-20210609-00410.
[7]	Broen JCA, van Laar JM. Mycophenolate mofetil, azathioprine and tacrolimus: mechanisms in rheumatology[J]. Nat Rev Rheumatol, 2020, 16(3): 167-178. DOI: 10.1038/s41584-020-0374-8.
[8]	Hannah J, Casian A, D'Cruz D. Tacrolimus use in lupus nephritis: a systematic review and meta-analysis[J]. Autoimmun Rev, 2016, 15(1): 93-101. DOI: 10.1016/j.autrev.2015.09.006.
[9]	Kronbichler A, Brezina B, Gauckler P, et al. Refractory lupus nephritis: When, why and how to treat[J]. Autoimmun Rev, 2019, 18(5): 510-518. DOI: 10.1016/j.autrev.2019.03.004.
[10]	Liu ZH, Zhang HT, Liu ZS, et al. Multitarget therapy for induction treatment of lupus nephritis: a randomized trial[J]. Ann Intern Med, 2015, 162(1): 18-26. DOI: 10.7326/M14-1030.