Mycophenolate mofetil for induction and maintenance of remission in microscopic polyangiitis with mild to moderate renal involvement - A prospective, open-label pilot trial

Clinical Journal of the American Society of Nephrology

Volumn 5, Issue 3, 2010, Pages 445-453

  Silva, Francisco ^a   Specks, Ulrich ^a   Kalra, Sanjay ^a   Hogan, Marie C ^a   Leung, Nelson ^a   Sethi, Sanjeev ^a   Fervenza, Fernando C ^a  

^a MAYO CLINIC   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

METHYLPREDNISOLONE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; NEUTROPHIL CYTOPLASMIC ANTIBODY; PREDNISONE;

ADULT; ARTICLE; AVASCULAR NECROSIS; BLOATING; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DIARRHEA; DOSE RESPONSE; DRUG DOSE INCREASE; DRUG DOSE REDUCTION; DRUG EFFECT; DRUG EFFICACY; DRUG WITHDRAWAL; FEMALE; GASTROINTESTINAL SYMPTOM; HEADACHE; HUMAN; KIDNEY FUNCTION; LEUKOPENIA; MALE; MICROSCOPIC POLYANGIITIS; NAUSEA; OUTCOME ASSESSMENT; PILOT STUDY; PROSPECTIVE STUDY; PROTEINURIA; RELAPSE; REMISSION; THERAPY EFFECT; TREATMENT DURATION; TREATMENT OUTCOME; TREATMENT RESPONSE; WEAKNESS;

ADMINISTRATION, ORAL; ADULT; AGED; AGED, 80 AND OVER; ANTIBODIES, ANTINEUTROPHIL CYTOPLASMIC; DRUG ADMINISTRATION SCHEDULE; DRUG THERAPY, COMBINATION; FEMALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; KIDNEY DISEASES; MALE; METHYLPREDNISOLONE; MICROSCOPIC POLYANGIITIS; MIDDLE AGED; MYCOPHENOLIC ACID; PEROXIDASE; PILOT PROJECTS; PREDNISONE; PROSPECTIVE STUDIES; RECURRENCE; REMISSION INDUCTION; SEVERITY OF ILLNESS INDEX; TIME FACTORS; TREATMENT OUTCOME;

EID: 77749277070     PISSN: 15559041     EISSN: 1555905X     Source Type: Journal    
DOI: 10.2215/CJN.06010809     Document Type: Article

References (35)

1. Jennette JC, Falk RJ, Andrassy K, Bacon BA, Churg J, Gross WL, Hagen EC, Hoffmann GS, Hunder GG, Kallenberg CGM, McCluskey RT, Sinico RA, Rees AJ, Van Es LA, Waldherr R, Wiik A: Nomenclature of systemic vasculitides: The proposal of an international consensus conference. Arthritis Rheum 37: 187-192, 1994
2. Guillevin L, Durand-Gasselin B, Cevallos R, Gayraud M, Lhote F, Callard P, Amouroux J, Casassus P, Jarrousse B: Microscopic polyangiitis: Clinical and laboratory findings in eighty-five patients. Arthritis Rheum 42: 421-430, 1999
3. Hoffman GS, Specks U: Anti-neutrophil cytoplasmic antibodies. Arthritis Rheum 41: 1521-1537, 1998
4. Savage CO, Winearls CG, Evans DJ, Rees AJ, Lockwood CM: Microscopic polyarteritis: Presentation, pathology and prognosis. Q J Med 56: 467-483, 1985
5. Nachman PH, Hogan SL, Jennette JC, Falk RJ: Treatment response and relapse in antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol 7: 33-39, 1996
6. Gayraud M, Guillevin L, le Toumelin P, Cohen P, Lhote F, Casassus P, Jarrousse B: Long-term follow-up of polyarteritis nodosa, microscopic polyangiitis, and Churg-Strauss syndrome: Analysis of four prospective trials including 278 patients. Arthritis Rheum 44: 666-675, 2001
7. Guillevin L, Cohen P, Mahr A, Arene JP, Mouthon L, Puechal X, Pertuiset E, Gilson B, Hamidou M, Lanoux P, Bruet A, Ruivard M, Vanhille P, Cordier JF: Treatment of polyarteritis nodosa and microscopic polyangiitis with poor prognosis factors: A prospective trial comparing glucocorticoids and six or twelve cyclophosphamide pulses in sixty-five patients. Arthritis Rheum 49: 93-100, 2003
8. Jayne D, Rasmussen N, Andrassy K, Bacon P, Cohen Tervaert JW, Dadoniene J, Ekstrand A, Gaskin G, Gregorini G, de Groot K, Gross W, Hagen EC, Mirapeix E, Pettersson E, Siegert C, Sinico A, Tesar V, Westman K, Pusey C: A randomized trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic autoantibodies. N Engl J Med 349: 36-44, 2003
9. Cohen J, Pinching AJ, Rees AJ, Peters DK: Infection and immunosuppression. A study of the infective complications of 75 patients with immunologically mediated disease. Q J Med 51: 1-15, 1982
10. Bradley JD, Brandt KD, Katz BP: Infectious complications of cyclophosphamide treatment for vasculitis. Arthritis Rheum 32: 45-53, 1989
11. Stillwell TJ, Benson RC Jr, DeRemee RA, McDonald TJ, Weiland LH: Cyclophosphamide-induced bladder toxicity in Wegener's granulomatosis. Arthritis Rheum 31: 465-470, 1988
12. Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS: Wegener granulomatosis: An analysis of 158 patients. Ann Intern Med 116: 488-498, 1992
13. Briggs WA, Choi MJ, Scheel PJ Jr: Successful mycophenolate mofetil treatment of glomerular disease. Am J Kidney Dis 31: 213-217, 1998
14. Ziswiler R, Steinmann-Niggli K, Kappeler A, Daniel C, Marti HP: Mycophenolic acid: A new approach to the therapy of experimental mesangial proliferative glomerulonephritis. J Am Soc Nephrol 9: 2055-2066, 1998
15. Miller G, Zimmerman R III, Radhakrishnan J, Appel G: Use of mycophenolate mofetil in resistant membranous nephropathy. Am J Kidney Dis 36: 250-256, 2000
16. Ginzler EM, Dooley MA, Aranow C, Kim MY, Buyon J, Merrill JT, Petri M, Gilkeson GS, Wallace DJ, Weisman MH, Appel GB: Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med 353: 2219-2228, 2005
17. Nowack R, Göbel U, Klooker P, Hergesell O, Andrassy K, Van Der Woude FJ: Mycophenolate mofetil for maintenance therapy of Wegener's granulomatosis and microscopic polyangiitis: A pilot study in 11 patients with renal involvement. J Am Soc Nephrol 10: 1965-1971, 1999
18. Langford CA, Talar-Williams C, Sneller MC: Mycophenolate mofetil for remission maintenance in the treatment of Wegener's granulomatosis. Arthritis Rheum 51: 278-283, 2004
19. Joy MS, Hogan SL, Jennette JC, Falk RJ, Nachman PH: A pilot study using mycophenolate mofetil in relapsing or resistant ANCA small vessel vasculitis. Nephrol Dial Transplant 20: 2725-2732, 2005
20. Stassen PM, Cohen Tervaert JW, Stegeman CA: Induction of remission in active anti-neutrophil cytoplasmic antibody-associated vasculitis with mycophenolate mofetil in patients who cannot be treated with cyclophosphamide. Ann Rheum Dis 66: 798-802, 2007
21. Franssen CF, Gans RO, Arends B, Hageluken C, ter Wee PM, Gerlag PG, Hoorntje SJ: Differences between antimyeloperoxidase-and anti-proteinase 3-associated renal disease. Kidney Int 47: 193-199, 1995
22. Hogan SL, Nachman PH, Wilkman AS, Jennette JC, Falk RJ: Prognostic markers in patients with antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol 7: 23-32, 1996
23. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130: 461-470, 1999
24. Russell KA, Wiegert E, Schroeder DR, Homburger HA, Specks U: Detection of anti-neutrophil cytoplasmic antibodies under actual clinical testing conditions. Clin Immunol 103: 196-203, 2002
25. Stone JH, Hoffman GS, Merkel PA, Min YI, Uhlfelder ML, Hellmann DB, Specks U, Allen NB, Davis JC, Spiera RF, Calabrese LH, Wigley FM, Maiden N, Valente RM, Niles JL, Fye KH, McCune JW, St Clair EW, Luqmani RA: A disease-specific activity index for Wegener's granulomatosis: Modification of the Birmingham Vasculitis Activity Score. International Network for the Study of the Systemic Vasculitides (INSSYS). Arthritis Rheum 44: 912-920, 2001
26. Merkel PA, Cuthbertson DD, Hellmich B, Hoffman GS, Jayne DR, Kallenberg CG, Krischer JP, Luqmani R, Mahr AD, Matteson EL, Specks U, Stone JH: Comparison of disease activity measures for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis. Ann Rheum Dis 68: 103-106, 2009
27. De Groot K, Rasmussen N, Bacon PA, Tervaert JW, Feighery C, Gregorini G, Gross WL, Luqmani R, Jayne DR: Randomized trial of cyclophosphamide versus methotrexate for induction of remission in early systemic antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum 52: 2461-2469, 2005
28. Goek ON, Stone JH: Randomized controlled trials in vasculitis associated with anti-neutrophil cytoplasmic antibodies. Curr Opin Rheumatol 17: 257-264, 2005
29. Oh JS, Lee CK, Kim YG, Nah SS, Moon HB, Yoo B: Clinical features and outcomes of microscopic polyangiitis in Korea. J Korean Med Sci 24: 269-274, 2009
30. Koukoulaki M, Jayne DR: Mycophenolate mofetil in antineutrophil cytoplasm antibodies-associated systemic vasculitis. Nephron Clin Pract 102: c100-c107, 2006
31. Hu W, Liu C, Xie H, Chen H, Liu Z, Li L: Mycophenolate mofetil versus cyclophosphamide for inducing remission of ANCA vasculitis with moderate renal involvement. Nephrol Dial Transplant 23: 1307-1312, 2008
32. Slot MC, Tervaert JW, Franssen CF, Stegeman CA: Renal survival and prognostic factors in patients with PR3-ANCA associated vasculitis with renal involvement. Kidney Int 63: 670-677, 2003
33. Booth AD, Almond MK, Burns A, Ellis P, Gaskin G, Neild GH, Plaisance M, Pusey CD, Jayne DR: Outcome of ANCA-associated renal vasculitis: A 5-year retrospective study. Am J Kidney Dis 41: 776-784, 2003
34. Halloran P, Mathew T, Tomlanovich S, Groth C, Hooftman L, Barker C: Mycophenolate mofetil in renal allograft recipients: A pooled efficacy analysis of three randomized, double-blind, clinical studies in prevention of rejection. The International Mycophenolate Mofetil Renal Transplant Study Groups. Transplantation 63: 39-47, 1997
35. Contreras G, Pardo V, Leclercq B, Lenz O, Tozman E, O'Nan P, Roth D: Sequential therapies for proliferative lupus nephritis. N Engl J Med 350: 971-980, 2004