Long-term outcome of mycophenolate mofetil treatment for patients with microscopic polyangiitis: an observational study in Chinese patients

Rheumatol Int. 2016 Jul;36(7):967-74. doi: 10.1007/s00296-016-3492-5. Epub 2016 May 11.

Abstract

This study aimed to retrospectively analyze the long-term outcome of mycophenolate mofetil (MMF) therapy for microscopic polyangiitis (MPA) with mild to moderate renal involvement in Chinese patients. Thirty-four MPA patients (24 females, 10 males, aged 44.7 ± 17 years, BVAS score 13.8 ± 3.2, SCr 2.2 ± 1.1 mg/dl) with SCr < 5 mg/dl and who received glucocorticoids plus MMF therapy for inducing and maintaining remission were included in this study. The remission and relapse rates, patient and renal survival rates and adverse events were retrospectively analyzed. We found that 31 (91.2 %) of 34 patients achieved remission and were continuously treated with glucocorticoids plus MMF for maintaining remission. The median duration of MMF treatment was 24 months (IQR 15-53 months) and follow-up time was 86 months (IQR 29-124 months). During the follow-up, 7 (22.6 %) patients relapsed, one patient died, and one patient progressed into end-stage renal disease. The 5-year patient and renal survival rates were 92.8 and 95.2 %, respectively. 11 (32.4 %) patients suffered 16 adverse events, 13 of which were pulmonary infection. In conclusion, glucocorticoids plus MMF regimen as induction and maintenance therapy could achieve high remission rate and good long-term renal survival in MPA patients with mild to moderate renal involvement. Prospective controlled trials with a large sample size are needed to confirm the efficacy of MMF in this population.

Keywords: Microscopic polyangiitis; Mycophenolate mofetil; Remission; Renal survival.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • China / epidemiology
  • Disease Progression
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / administration & dosage*
  • Immunosuppressive Agents / adverse effects
  • Kaplan-Meier Estimate
  • Kidney Diseases / diagnosis
  • Kidney Diseases / drug therapy*
  • Kidney Diseases / immunology
  • Kidney Diseases / mortality
  • Male
  • Microscopic Polyangiitis / diagnosis
  • Microscopic Polyangiitis / drug therapy*
  • Microscopic Polyangiitis / immunology
  • Microscopic Polyangiitis / mortality
  • Middle Aged
  • Mycophenolic Acid / administration & dosage*
  • Mycophenolic Acid / adverse effects
  • Opportunistic Infections / chemically induced
  • Opportunistic Infections / immunology
  • Remission Induction
  • Respiratory Tract Infections / chemically induced
  • Respiratory Tract Infections / immunology
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Mycophenolic Acid