Mycophenolate mofetil versus cyclophosphamide as induction therapy in lupus nephritis at one year- a prospective cohort study.

Abstract

Objective: To compare efficacy of mycophenolate mofetil to intravenous cyclophosphamide as inductive therapy for lupus nephritis at 1 years after induction. Study Design: Observational Prospective Cohort study. Setting: Department of Rheumatology, Fauji Foundation Hospital Rawalpindi, Pakistan, Period: 26th Jan, 2024 to 28th Feb 2025. Methods: Sixty two LN patients of both genders and at least 18 years of age were recruited into MMF & CYC groups with equal numbers in each group. Induction therapy with MMF & IV CYC were given for 6 months in the respective group followed by MMF for next 6 months. CRR, PRR and TRR were obtained at 1 year after induction. Excel software was used to analyse the data obtained. Results: The mean age of the patients in MMF group was 39.68±5 years while the mean age of the patients in CYC group was 37.45±4.87 years. Female gender outnumbered in both the groups. At 1 year of induction therapy, complete renal remission (CRR) in MMF group was observed in 77% patients while in CYC group it was observed in 29% patients. Partial renal remission (PRR) in MMF group was observed in 16% patients while in CYC group it was observed in 16% patients. Total renal remission (TRR) in MMF group was observed in 94% patients while in CYC group it was observed in 45% patients. Conclusion: MMF is more affective as induction therapy for lupus nephritis as compared to IV CYC. Moreover it is more safe and tolerable.