Home
My Account
About Us
Forum
Contact us
الواجهة العربية
epharmaweb.com
Medical News Medical News
Aricles Articles
Events Events
Guidelines Guidelines
Videos Library Videos Library
Diseases Diseases
Follow us : facebook twitter Digg Linkedin Boxiz
Newsletter

Please select the categories you are intersted in:
News Articles Guidelines Events Videos Journals' abstracts

Latest Subscribers
Advanced Search »



Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis



Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis

Mary Anne Dooley, M.D., M.P.H., David Jayne, M.D., Ellen M. Ginzler, M.D., M.P.H., David Isenberg, M.D., Nancy J. Olsen, M.D., David Wofsy, M.D., Frank Eitner, M.D., Gerald B. Appel, M.D., Gabriel Contreras, M.D., M.P.H., Laura Lisk, B.Sc., and Neil Solomons, M.D.

The New England Journal of Medicine,
365:20, November 17, 2011

Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis

Background
Maintenance therapy, often with azathioprine or mycophenolate mofetil, is required to consolidate remission and prevent relapse after the initial control of lupus nephritis.

Methods
We carried out a 36-month, randomized, double-blind, double-dummy, phase 3 study comparing oral mycophenolate mofetil (2 g per day) and oral azathioprine (2 mg per kilogram of body weight per day), plus placebo in each group, in patients who met response criteria during a 6-month induction trial. The study group underwent repeat randomization in a 1:1 ratio. Up to 10 mg of prednisone per day or its equivalent was permitted. The primary efficacy end point was the time to treatment failure, which was defined as death, end-stage renal disease, doubling of the serum creatinine level, renal flare, or rescue therapy for lupus nephritis. Secondary assessments included the time to the individual components of treatment failure and adverse events.

Results
A total of 227 patients were randomly assigned to maintenance treatment (116 to mycophenolate mofetil and 111 to azathioprine). Mycophenolate mofetil was superior to azathioprine with respect to the primary end point, time to treatment failure (hazard ratio, 0.44; 95% confidence interval, 0.25 to 0.77; P=0.003), and with respect to time to renal flare and time to rescue therapy (hazard ratio, <1.00; P<0.05). Observed rates of treatment failure were 16.4% (19 of 116 patients) in the mycophenolate mofetil group and 32.4% (36 of 111) in the azathioprine group. Adverse events, most commonly minor infections and gastrointestinal disorders, occurred in more than 95% of the patients in both groups (P=0.68). Serious adverse events occurred in 33.3% of patients in the azathioprine group and in 23.5% of those in the mycophenolate mofetil group (P=0.11), and the rate of withdrawal due to adverse events was higher with azathioprine than with mycophenolate mofetil (39.6% vs. 25.2%, P=0.02).

Conclusions
Mycophenolate mofetil was superior to azathioprine in maintaining a renal response to treatment and in preventing relapse in patients with lupus nephritis who had a response to induction therapy.







اضغط هنا للقراءة باللغة العربية

Prepared by: Dr. Awss Zidan






Forgot your password


sign up

Consultants Corner

Dr . Dirar Abboud

Dr . Dirar Abboud Hepatologist – Gastroenterologist

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Yaser Habrawi , F.R.C.S.Ed

Yaser Habrawi , F.R.C.S.Ed Consultant Ophthalmologist

Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology

Dr. Talal Sabouni

Dr. Talal Sabouni UROLOGY AND KIDNEY TRANSPLANT

Dr. Faisal Dibsi

Dr. Faisal Dibsi Specialist of Otolaryngology - Head and Neck Surgery
Poll

Which of the following you are mostly interested in?

Cancer Research
Mental Health
Heart Disease & Diabetes
Sexual Health
Obesity and Healthy Diets
Mother & Child Health

Disclaimer : This site does not endorse or recommend any medical treatment, pharmaceuticals or brand names. More Details