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MYCOPHENOLATE MOFETIL IN RELAPSING LUPUS NEPHRITIS Chow YW, Yahya R, Visvanathan R Department of Nephrology,  Kuala Lumpur Hospital
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MYCOPHENOLATE MOFETIL IN LUPUS NEPHRITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Relapse Rate with current standard care Median: 38 months 39 38 Standard CYC & pulse MP Cortes-Hernandez 2003 Varied treatment Low dose steroid with Azathioprine Pulse CYC, pulse MP or combination Corticosteroid & immunosupressive Treatment Within 18 months 59 91 Mosca 2002 Mean : 40 months to first flare 37 46 El Hachmi 2003 CR: median 36 mths PR: median 18 mths 45 92 Illei 2002 Within 103 months 51 211 Beji 2005 Duration % n Publications
Objective   ,[object Object],[object Object],[object Object]
Design & Methods   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Design & Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definitions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Result  30 2.0 IV M 27 Pt 6 10 2.0 IV F 30 Pt 5 27 2.0 IV F 28 Pt 4 6 2.0 IV F 17 Pt 3 18 1.0 V F 24 Pt 2 22 2.0 V F 28 Pt 1 F/up (mth) MMF dose WHO Class Sex Age
Result R 1.5 15.4 Skin, Jt Pt 6 R 1.5 14.6 Skin, Jt Pt 5 R 1.5 13.0 Skin, Jt Pt 4 R 2.0 13.4 Hemato, CNS Pt 3 R 2.4 12.0 CNS, Skin Pt 2 R 2.0 12.3 Hemato, Skin Pt 1 MMF Indi Aza (mg/kg) CYC (g) SLE Criteria
Result PR Losartan 100mg dly -- Pt 6 CR -- Perindopril 8mg dly Pt 5 PR -- Perindopril 8mg dly Pt 4 NR -- Enalapril 10mg BD Pt 3 NR* Telmisartan 80mg dly Perindopril 8mg dly Pt 2 CR Losartan 100mg dly Perindopril 8mg dly Pt 1 Response ARB ACEI
Result ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Result ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Result:  24 hour urine protein    1.62  +  0.89 to 0.86  +  1.22g/24 hours
Result-  Serum albumin  23.00  +  5.13 to 31.17  +  10.89g/L
Result-  Serum cholesterol  7.87  +  3.61 to 5.65  +  2.00mmol/L
Result-  Renal function  92.67  +  40.14 to 84.17  +  14.28umol/L
Results-   eGFR  81.41  +  38.98 to  83.39  +  17.25mls/min/ 1.73m2
Results -   C3   0.35  +  0.19 to 0.64  +  0.49g/L
Adverse Events ,[object Object],[object Object]
Conclusion   ,[object Object]
Discussion
MYCOPHENOLATE MOFETIL IN LUPUS NEPHRITIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 

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Mycophenolate Mofetil In Relapsing Lupus Nephritis

  • 1. MYCOPHENOLATE MOFETIL IN RELAPSING LUPUS NEPHRITIS Chow YW, Yahya R, Visvanathan R Department of Nephrology, Kuala Lumpur Hospital
  • 2.
  • 3.
  • 4. Relapse Rate with current standard care Median: 38 months 39 38 Standard CYC & pulse MP Cortes-Hernandez 2003 Varied treatment Low dose steroid with Azathioprine Pulse CYC, pulse MP or combination Corticosteroid & immunosupressive Treatment Within 18 months 59 91 Mosca 2002 Mean : 40 months to first flare 37 46 El Hachmi 2003 CR: median 36 mths PR: median 18 mths 45 92 Illei 2002 Within 103 months 51 211 Beji 2005 Duration % n Publications
  • 5.
  • 6.
  • 7.
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  • 9.
  • 10. Result 30 2.0 IV M 27 Pt 6 10 2.0 IV F 30 Pt 5 27 2.0 IV F 28 Pt 4 6 2.0 IV F 17 Pt 3 18 1.0 V F 24 Pt 2 22 2.0 V F 28 Pt 1 F/up (mth) MMF dose WHO Class Sex Age
  • 11. Result R 1.5 15.4 Skin, Jt Pt 6 R 1.5 14.6 Skin, Jt Pt 5 R 1.5 13.0 Skin, Jt Pt 4 R 2.0 13.4 Hemato, CNS Pt 3 R 2.4 12.0 CNS, Skin Pt 2 R 2.0 12.3 Hemato, Skin Pt 1 MMF Indi Aza (mg/kg) CYC (g) SLE Criteria
  • 12. Result PR Losartan 100mg dly -- Pt 6 CR -- Perindopril 8mg dly Pt 5 PR -- Perindopril 8mg dly Pt 4 NR -- Enalapril 10mg BD Pt 3 NR* Telmisartan 80mg dly Perindopril 8mg dly Pt 2 CR Losartan 100mg dly Perindopril 8mg dly Pt 1 Response ARB ACEI
  • 13.
  • 14.
  • 15. Result: 24 hour urine protein 1.62 + 0.89 to 0.86 + 1.22g/24 hours
  • 16. Result- Serum albumin 23.00 + 5.13 to 31.17 + 10.89g/L
  • 17. Result- Serum cholesterol 7.87 + 3.61 to 5.65 + 2.00mmol/L
  • 18. Result- Renal function 92.67 + 40.14 to 84.17 + 14.28umol/L
  • 19. Results- eGFR 81.41 + 38.98 to 83.39 + 17.25mls/min/ 1.73m2
  • 20. Results - C3 0.35 + 0.19 to 0.64 + 0.49g/L
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  • 28.