Mycophenolate Mofetil in Primary Glomerulonephritis

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This document reports on a study examining the use of mycophenolate mofetil (MMF) for treating primary glomerulonephritis. Four patients with focal segmental glomerulosclerosis (FSGS) or membranous nephropathy received MMF for at least 6 months. Results showed reduced urine protein levels and improved or stable kidney function in most patients, suggesting MMF may be useful for treating these conditions. However, larger randomized controlled trials are still needed to validate MMF's efficacy.

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MYCOPHENOLATE MOFETIL IN THE TREATMENT OF PRIMARY GLOMERULONEPHRITIS Chow YW, Yahya R, Visvanathan R Department of Nephrology, Kuala Lumpur Hospital

Objective Patients with primary glomerulonephritis (GN) Steroids or Cytotoxic agents Treatment resistance Frequent relapses

Objective ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Design & Methods Four patients Focal Segmental Glomerulosclerosis (FSGS) Membranous nephropathy (MN) 3 1 Partial Response to Steroids and Cyclosporine Steroid Resistance No Response to Steroids and Cyclophosphamide 1 2 1

Design & Methods ,[object Object],[object Object],[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]

Results ,[object Object],Telmisartan 80mg dly Enalapril 10mg dly 4 - Enalapril 20mg BD 3 Irbesartan 300mg dly Perindopril 8mg dly 2 Telmisartan 80mg dly Enalapril 20mg BD 1 ARB ACEI Patient

Results 1 - Membranous GN 2 1 FSGS Partial Remission Complete remission

Results- 24 hour Urine Protein 24 hour urine protein: 7.58 + 10.10 to 0.91 + 0.94g/24 hours (p=0.03)

Results- Serum Albumin Serum albumin: 18 + 10.49 to 39 + 4.25g/L (p=0.71)

Results- Serum Cholesterol Serum cholesterol: 11.38 + 1.72 to 5.15 + 1.07mmol/l (p=0.46)

Results- Serum Creatinine Serum Creatinine: 183.75 + 63.93 to 127.50 + 38.20umol/l (p=0.68)

Results- eGFR eGFR: 38.76 + 16.25 to 56.52 + 18.81mls/min/1.73m2 (p=0.68)

Results- Adverse Events ,[object Object],[object Object],[object Object]

Discussion Clinical Trials on MMF in FSGS

CR-1, NR-1 12 1.0-2.0 2 Tasanatong J Ass Med Thai, 06’ CR-5, PR-16, R-7, NR14 43 TOTAL CR-1. NR-1 6-8 1.5 2 Tang, J Nephro 05’ CR-0, PR-8, NR-10 6 2.0 18 Cattran, Clin Neph 04’ CR-1, PR-1 12 2.0 2 Day, NDT 02’ CR-2, PR-6 R-7, NR-2 NA-1 4-24 1.5-2.0 18 Choi, KI 02’ PR 21 2.0 1 Choi, AJKD 98’ Outcome F/up (mths) MMF Dose n

Discussion Clinical Trials on MMF in Membranous Nephropathy

CR-2, PR-9 R-3, NR-2 , NA-1 4-25 1.5-2.0 17 Choi, KI 02’ CR-3, PR-13, R-9, NR-10 36 TOTAL PR-2, R-6, NR-8 8 0.5-2.0 16 Miller, AJKD 00’ PR-2 CR-1 8-10 1.5-2 3 Choi, AJKD 98 Outcome F/up (mths) MMF Dose (g/day) n

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