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Lupus Nephritis

How does conversion from MMF to enteric-coated mycophenolate sodium affect renal response?

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Patients with lupus nephritis (LN) who switch from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) have similar short-term renal responses to patients on continuous MMF, according to a study.

EC-MPS was developed to decrease the adverse gastrointestinal side effects of MMF, a commonly used induction and maintenance therapy in patients with LN.

In this study, the medical records for 54 patients with LN were reviewed. Overall, 34 patients converted from MMF to EC-MPS (nonmedical switching group) and 20 patients continued to receive MMF treatment. Responders were considered patients who achieved complete remission or partial remission before the change.

At baseline, the nonmedical switching group had higher proteinuria. After converting to EC-MPS, serum creatinine concentration and estimated glomerular filtration rates improved, however, proteinuria was elevated. Responders in this group had lower proteinuria and higher complement 3 levels.

A subgroup analysis found that daily urine protein, anti-double-stranded DNA antibody levels, estimated glomerular filtration rate, and complements 3 and 4 appeared comparable after switching.

Liao YW, Hung WT, Chen YM, et al. Comparison of Renal Responses Between Continuous Mycophenolate Mofetil and Conversion from Mycophenolate Mofetil to Enteric-Coated Mycophenolate Sodium in Lupus Nephritis. J Clin Rheumatol. 2021;DOI: 10.1097/RHU.0000000000001780. Epub ahead of print. PMID: 34371515.