Five-years drug survival of mycophenolate mofetil therapy in patients with systemic lupus erythematosus: Comparison between renal and non-renal involvement - 18/11/21
, Francesco Natalucci, Carmelo Pirone, Valeria Orefice, Viviana Antonella Pacucci, Cristina Garufi, Simona Truglia, Francesca Romana Spinelli, Cristiano Alessandri, Fabrizio ContiBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | EULAR recommendations for the management of SLE patients suggest the administration of MMF to treat different SLE related features. |
• | Few data are available about the efficacy of MMF in other than Lupus Nephritis manifestations in a real-life scenario. |
• | We found an overall retention rate up to 60% after 5 years of MMF treatment, without differences in terms of drug indications. |
• | Persistent remission was the first cause of MMF discontinuation. |
• | MMF resulted able to prevent chronic damage progression. |
Abstract |
Objective |
The EULAR recommendations underline the use of MMF for Lupus Nephritis (LN) but also for the treatment of moderate/severe non-renal manifestations (NLN). This study aims at evaluating the 5-years drug retention rate (DRR) of MMF in a SLE cohort in a real-life scenario. Secondly, we investigated the MMF influence to control chronic damage progression.
Methods |
We performed a longitudinal study including all the SLE patients starting MMF in our Lupus Clinic (from 2008 to 2020). The DRR was estimated using the Kaplan-Meier method.
Results |
We evaluated 162 SLE patients (M/F 22/140). The most frequent indications for prescribing MMF were LN (101 patients, 62.3%) and musculoskeletal manifestations (39, 24.1%) followed by NPSLE (10, 6.2%) and other manifestations (12, 7.4%). We registered a median treatment duration of 30 months (IQR 55). At 60 months follow-up we observed a DRR of 61.1% for LN patients, which was similar to that registered for patients without renal involvement (60.5%). The DRR was higher in the subgroup of patients with joint involvement (75.4%, P non-significant). During the overall observation period, 92 patients (59.2%) discontinued MMF. The main cause of withdrawal was the achievement of remission, observed in 20 patients (21.7%). Moreover, MMF resulted able to control chronic damage progression, as demonstrated by the lack of significant increase in the median SDI values (baseline: 0.6, IQR 1; last: 0.93, IQR 1).
Conclusions |
Our finding suggested that MMF is a safe and effective drug for SLE manifestations other than LN, especially for joint involvement. Moreover, it was able to control the chronic damage progression.
Le texte complet de cet article est disponible en PDF.Keywords : Systemic lupus erythematosus, Mycophenolate mofetil, Drug retention rate
Plan
Vol 88 - N° 6
Article 105246- décembre 2021 Retour au numéro
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