Maintenance immunosuppressive drug therapy is necessary to counter the propensity of lupus nephritis to relapse. Claims that mycophenolate mofetil might be the magic bullet for both induction and maintenance therapies merit critical reappraisal due to inconsistent evidence of the superiority of mycophenolate mofetil over azathioprine, as well as its inordinately greater cost.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Austin, H. A. 3rd et al. Therapy of lupus nephritis: controlled trial of prednisone and cytotoxic drugs. N. Engl. J. Med. 314, 614–619 (1986).
Ginzler, E. M. et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N. Engl. J. Med. 353, 2219–2228 (2005).
Donadio, J. V. Jr et al. Treatment of diffuse proliferative lupus nephritis with prednisone and combined prednisone and cyclophosphamide. N. Engl. J. Med. 299, 1151–1155 (1978).
Boumpas, D. T. et al. Controlled trial of pulse methylprednisolone versus two regimens of pulse cyclophosphamide in severe lupus nephritis. Lancet 340, 741–745 (1992).
Contreras, G. et al. Sequential therapies for proliferative lupus nephritis. N. Engl. J. Med. 350, 971–980 (2004).
Dooley, M. A. et al. Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis. N. Engl. J. Med. 365, 1886–1895 (2011).
Stoenoiu, M. S. et al. Repeat kidney biopsies fail to detect differences between azathioprine and mycophenolate mofetil maintenance therapy for lupus nephritis: data from the MAINTAIN nephritis trial. Nephrol. Dial. Transplant. http://dx.doi.org/10.1093/ndt/gfr553.
Remuzzi, G. et al. Mycophenolate mofetil versus azathioprine for prevention of chronic allograft dysfunction in renal transplantation: the MYSS follow-up randomized, controlled clinical trial. J. Am. Soc. Nephrol. 18, 1973–1985 (2007).
Pham, P. T. & Pham, P. C. The impact of mycophenolate mofetil versus azathioprine as adjunctive therapy to cyclosporine on the rates of renal allograft loss due to glomerular disease recurrence. Nephrol. Dial. Transplant. http://dx.doi.org/10.1093/ndt/gfr731.
Hiemstra, T. F. et al. Mycophenolate mofetil vs azathioprine for remission maintenance in antineutrophil cytoplasmic antibody-associated vasculitis. JAMA 304, 2381–2388 (2010).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Balow, J. Perspectives on maintenance therapy in lupus nephritis. Nat Rev Nephrol 8, 136–138 (2012). https://doi.org/10.1038/nrneph.2012.17
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2012.17