Efficacy and safety of mycophenolate mofetil versus cyclophosphamide in the treatment of Henoch-Schönlein purpura nephritis with nephrotic-range proteinuria in children: a prospective randomized controlled trial

GENG Hai-Yun, CHEN Chao-Ying, LI Hua-Rong, TU Juan, DU Pei-Wei, XIA Hua

Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (4) : 338-342.

PDF(1172 KB)
PDF(1172 KB)
Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (4) : 338-342. DOI: 10.7499/j.issn.1008-8830.2012145
CLINICAL RESEARCH

Efficacy and safety of mycophenolate mofetil versus cyclophosphamide in the treatment of Henoch-Schönlein purpura nephritis with nephrotic-range proteinuria in children: a prospective randomized controlled trial

  • GENG Hai-Yun, CHEN Chao-Ying, LI Hua-Rong, TU Juan, DU Pei-Wei, XIA Hua
Author information +
History +

Abstract

Objective To study the efficacy and safety of mycophenolate mofetil (MMF) versus cyclophosphamide (CTX) in the treatment of children with Henoch-Schönlein purpura nephritis (HSPN) and nephrotic-range proteinuria. Methods A prospective clinical trial was conducted in 68 pediatric patients who were admitted to the Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics and who were diagnosed with HSPN and nephrotic-range proteinuria from August 2016 to November 2019. The patients were randomly divided into two groups:MMF treatment (n=33) and CTX treatment (n=35). The two groups were compared in terms of complete remission rate, response rate (complete remission + partial remission), urinary protein clearance time, and adverse events. Results At months 3, 6, and 12 of treatment, there was no significant difference in the complete remission rate and the response rate between the MMF treament and CTX treatment groups (P > 0.05). There was also no significant difference between the two groups in the urinary protein clearance time and the incidence rate of adverse events (P > 0.05). Conclusions MMF and CTX have similar efficacy and safety in the treatment of HSPN children with nephrotic-range proteinuria.

Key words

Henoch-Schö / nlein purpura nephritis / Pharmacotherapy / Immunosuppressive agent / Mycophenolate mofetil / Child

Cite this article

Download Citations
GENG Hai-Yun, CHEN Chao-Ying, LI Hua-Rong, TU Juan, DU Pei-Wei, XIA Hua. Efficacy and safety of mycophenolate mofetil versus cyclophosphamide in the treatment of Henoch-Schönlein purpura nephritis with nephrotic-range proteinuria in children: a prospective randomized controlled trial[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(4): 338-342 https://doi.org/10.7499/j.issn.1008-8830.2012145

References

[1] Tan JX, Tang Y, Xu YC, et al. The clinicopathological characteristics of Henoch-Schönlein purpura nephritis with presentation of nephrotic syndrome[J]. Kidney Blood Press Res, 2019, 44(4):754-764.
[2] Delbet JD, Hogan J, Aoun B, et al. Clinical outcomes in children with Henoch-Schönlein purpura nephritis without crescents[J]. Pediatr Nephrol, 2017, 32(7):1193-1199.
[3] Chapter 11:Henoch-Schönlein purpura nephritis[J]. Kidney Int Suppl(2011), 2012, 2(2):218-220.
[4] Chen YH, Sun JH, Zou K, et al. Treatment for lupus nephritis:an overview of systematic reviews and meta-analyses[J]. Rheumatol Int, 2017, 37(7):1089-1099.
[5] Basu B, Babu BG, Mahapatra TK. Long-term efficacy and safety of common steroid-sparing agents in idiopathic nephrotic children[J]. Clin Exp Nephrol, 2017, 21(1):143-151.
[6] Du B, Jia Y, Zhou WH, et al. Efficacy and safety of mycophenolate mofetil in patients with IgA nephropathy:an update meta-analysis[J]. BMC Nephrol, 2017, 18(1):245.
[7] 张建江, 贾莉敏, 史佩佩, 等. 吗替麦考酚酯联合糖皮质激素治疗儿童紫癜性肾炎的疗效观察[J]. 中华肾脏病杂志, 2017, 33(9):670-677.
[8] 中华医学会儿科学分会肾脏病学组. 儿童常见肾脏疾病诊治循证指南(二):紫癜性肾炎的诊治循证指南(试行)[J]. 中华儿科杂志, 2009, 47(12):911-913.
[9] 中华医学会儿科学分会肾脏病学组.儿童常见肾脏疾病诊治循证指南(一):激素敏感、复发/依赖肾病综合征诊治循证指南(试行)[J].中华儿科杂志, 2009, 47(3):167-170.
[10] Kellum JA, Lameire N, Aspelin P, et al. Kidney disease:improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury[J]. Kidney Int Suppl, 2012, 2(1):1-138.
[11] 中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华心血管病杂志, 2011, 39(7):579-616.
[12] Counahan R, Winterborn MH, White RH, et al. Prognosis of Henoch-Schönlein nephritis in children[J]. Br Med J, 1977, 2(6078):11-14.
[13] 俞全胜, 朱光华, 何威逊, 等. 霉酚酸酯与环磷酰胺治疗肾病综合征型紫癜性肾炎疗效比较[J]. 临床儿科杂志, 2007, 25(4):271-273.
[14] 中华医学会儿科学分会肾脏学组. 紫癜性肾炎诊治循证指南(2016)[J]. 中华儿科杂志, 2017, 55(9):647-651.
[15] Yu Y, Chen JJ, Yin HL, et al. Efficacy of steroid and immunosuppressant combined therapy in Chinese patients with Henoch-Schönlein purpura nephritis:a retrospective study[J]. Int Immunopharmacol, 2020, 81:106229.
[16] Li XQ, Tang MM, Yao XF, et al. A clinicopathological comparison between IgA nephropathy and Henoch-Schönlein purpura nephritis in children:use of the Oxford classification[J]. Clin Exp Nephrol, 2019, 23(12):1382-1390.
[17] Song YR, Guo WL, Sheng M, et al. Risk factors associated with renal crescentic formation in pediatric Henoch-Schönlein purpura nephritis:a retrospective cohort study[J]. BMC Pediatr, 2020, 20(1):501.
[18] Lu ZH, Song JF, Mao JH, et al. Evaluation of mycophenolate mofetil and low-dose steroid combined therapy in moderately severe Henoch-Schönlein purpura nephritis[J]. Med Sci Monit, 2017, 23:2333-2339.
[19] Hackl A, Becker JU, Körner LM, et al. Mycophenolate mofetil following glucocorticoid treatment in Henoch-Schönlein purpura nephritis:the role of early initiation and therapeutic drug monitoring[J]. Pediatr Nephrol, 2018, 33(4):619-629.

PDF(1172 KB)

Accesses

Citation

Detail

Sections
Recommended

/