Terapia di mantenimento della glomerulonefrite lupica con micofenolato mofetile: risultati di uno studio condotto su 70 pazienti

Systemic lupus erithematosus (LES) is an autoimmune disease that can potentially involve any organ or system of the human body. Glomerulonephritis (GN) has been recognized as the most frequent severe manifestation of LES leading to poor long term prognosis. In the treatment of lupus GN, several therapeutic approaches, all including immunosuppressive drugs such as cyclophosphamide, azathioprine (AZA), or cyclosporine A (CYA) have been used. The short and long term toxicity of these drugs limits their use in a substantial number of patients. Mycophenolate mofetil (MMF) is an immunosuppressant which provides protection against transplant rejection. MMF has been more recently used in many autoimmune inflammatory conditions, including SLE. Over the last few years MMF has emerged as an alternative regimen mainly for patients with SLE manifestations refractory to other therapies. Since January 1999 we have treated 70 SLE patient with diffuse proliferative GN followed-up from three Northern Italian Rheumatological Centres: Padova, Brescia and Milano. In this 54-month, observational, prospective study 40 were treated with MMF and compared with 30 treated with standard therapy: AZA or CYA. This study has shown that MMF is highly effective and generally well tolerated.