American Journal of Kidney Diseases
Volume 52, Issue 4 , Pages 699-705 , October 2008

Mycophenolate Mofetil Monotherapy in Membranous Nephropathy: A 1-Year Randomized Controlled Trial

  • Bertrand Dussol, MD

      Affiliations

    • Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception et Université Aix-Marseille II, France
    • Corresponding Author InformationAddress correspondence to Bertrand Dussol, MD, Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception, 147 Bd Baille, 13385 Marseille Cedex 5, France
    • ,
  • Sophie Morange, MD

      Affiliations

    • Centre d'Investigation Clinique, AP-HM/INSERM, Marseille, France
    • ,
  • Stéphane Burtey, MD

      Affiliations

    • Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception et Université Aix-Marseille II, France
    • ,
  • Monica Indreies, MD

      Affiliations

    • Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception et Université Aix-Marseille II, France
    • ,
  • Elisabeth Cassuto, MD

      Affiliations

    • Service de Néphrologie, Hôpital Pasteur, CHU Nice, France
    • ,
  • Georges Mourad, MD

      Affiliations

    • Service de Néphrologie et Transplantation, Hôpital Lapeyronie, CHU Montpellier, France
    • ,
  • Emmanuel Villar, MD

      Affiliations

    • Service de Néphrologie, Hôpital Sud, CHU Lyon, France
    • ,
  • Claire Pouteil-Noble, MD

      Affiliations

    • Service de Néphrologie, Hôpital Sud, CHU Lyon, France
    • ,
  • Huseyin Karaaslan, MD

      Affiliations

    • Service de Néphrologie, Hôpital Edouard Herriot, CHU Lyon, France
    • ,
  • Hélène Sichez, MD

      Affiliations

    • Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception et Université Aix-Marseille II, France
    • ,
  • Catherine Lasseur, MD

      Affiliations

    • Service de Néphrologie, Hôpital Pellegrin, CHU Bordeaux, France
    • ,
  • Yashou Delmas, MD

      Affiliations

    • Service de Néphrologie, Hôpital Pellegrin, CHU Bordeaux, France
    • ,
  • Marie-Béatrice Nogier, MD

      Affiliations

    • Service de Néphrologie, Hôpital Rangueil, CHU Toulouse, France
    • ,
  • Mohamed Fathallah

      Affiliations

    • Centre d'Investigation Clinique, AP-HM/INSERM, Marseille, France
    • ,
  • Anderson Loundou, StaSciD

      Affiliations

    • Unité d'Epidémiologie Prévention et Santé Publique, Faculté de Médecine de la Timone, Marseille, France
    • ,
  • Valérie Mayor, MD

      Affiliations

    • Roche, Neuilly sur Seine, France
    • ,
  • Yvon Berland, MD

      Affiliations

    • Centre de Néphrologie et de Transplantation rénale, Hôpital de la Conception et Université Aix-Marseille II, France

Received 19 October 2007 ,Accepted 23 April 2008.

References 

  1. Haas M, Meehan SM, Karrison TG, Spargo BH. Changing etiologies of unexplained adult nephrotic syndrome: A comparison of renal biopsy findings from 1976-1979 and 1995-1997. Am J Kidney Dis. 1997;30:621–631
  2. Kincaid-Smith P. Pharmacological management of membranous nephropathy. Curr Opin Nephrol Hypertens. 2002;11:149–154
  3. Muirhead N. Management of idiopathic membranous nephropathy: Evidence-based recommendations. Kidney Int Suppl. 1999;70:S47–S55
  4. Glassock RJ. The treatment of idiopathic membranous nephropathy: A dilemma or a conundrum. Am J Kidney Dis. 2004;44:562–566
  5. Cattran DC. Idiopathic membranous nephropathy. Kidney Int. 2001;59:1983–1994
  6. Shiiki H, Saito T, Nishitani Y, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004;65:1400–1407
  7. Cattran DC, Pei Y, Greenwood CM, et al. Predicting chronic renal insufficiency in idiopathic membranous glomerulonephritis. Kidney Int. 1992;42:960–966
  8. Torres A, Dominguez-Gil B, Carreno A, et al. Conservative versus immunosuppressive treatment of patients with idiopathic membranous nephropathy. Kidney Int. 2002;61:219–227
  9. Ahuja M, Goumenos D, Shortland JR, Gerakis A, Brown CB. Does immunosuppression with prednisolone and azathioprine alter the progression of idiopathic membranous nephropathy?. Am J Kidney Dis. 1999;34:521–529
  10. Perna A, Schieppati A, Zamora J, Giuliano G, Braun N, Remuzzi G. Immunosuppressive treatment for idiopathic membranous nephropathy: A systematic review. Am J Kidney Dis. 2004;44:385–401
  11. Praga A, Barrio V, Fernandez Juarez G, Luno J Grupo Espanol de Estudio de le Nephropatia membranosa. Tacrolimus monotherapy in membranous nephropathy: A randomized controlled trial. Kidney Int. 2007;71:924–930
  12. Jha V, Ganguli A, Saha T, et al. A randomized, controlled trial of steroids and cyclophosphamide in adults with nephrotic syndrome caused by idiopathic membranous nephropathy. J Am Soc Nephrol. 2007;18:1899–1904
  13. Penny MJ, Boyd RA, Hall BM. Mycophenolate mofetil prevents the induction of active Heymann nephritis: Association with Th2 cytokine inhibition. J Am Soc Nephrol. 1998;9:2272–2282
  14. Ziswiler R, Steinmann-Niggli K, Kappeler A, et al. Mycophenolic acid: A new approach to the therapy of experimental mesangial proliferative glomerulonephritis. J Am Soc Nephrol. 1998;9:2055–2066
  15. Miller G, Zimmermann R, Radhakrishnan , Appel G. Use of mycophenolate mofetil in resistant membranous nephropathy. Am J Kidney Dis. 2000;36:250–256
  16. Choi MJ, Eustace JA, Gimenez LF, et al. Mycophenolate mofetil treatment for primary glomerular diseases. Kidney Int. 2002;61:1098–1114
  17. Polenakovic M, Grcevska L, Dzikova S. Mycophenolate mofetil in treatment of idiopathic stages III-IV membranous nephropathy. Nephrol Dial Transplant. 2003;18:1234–1235
  18. Segarra A, Amoedo ML, Martinez Garcia JM, et al. Efficacy and safety of ‘rescue therapy’ with mycophenolate mofetil in resistant primary glomerulonephritis—A multicenter study. Nephrol Dial Transplant. 2007;22:1351–1360
  19. Sahin GM, Sahin S, Kantarci G, Ergin H. Mycophenolate mofetil treatment of therapy-resistant glomerulopathies. Nephrology (Carlton). 2007;12:285–288
  20. Cattran D. Management of membranous nephropathy: When and what for treatment?. J Am Soc Nephrol. 2005;16:1188–1194
  21. Cattran DL, Appel GB, Hebert LA, et al. Cyclosporine in patients with steroid-resistant membranous nephropathy: A randomized trial. Kidney Int. 2001;59:1484–1490
  22. Ponticelli C, Zucchelli P, Imbasciati E, et al. Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy. N Engl J Med. 1984;310:946–950
  23. Ponticelli C, Passerini P, Salvadori M, et al. A randomized pilot trial comparing methylprednisolone plus a cytotoxic agent versus synthetic adrenocorticotropic hormone in idiopathic membranous nephropathy. Am J Kidney Dis. 2006;47:233–240
  24. Schieppati A, Mosconi L, Perna A, et al. Prognosis of untreated patients with idiopathic membranous nephropathy. N Engl J Med. 1993;329:85–89
  25. Granger DK ERL B 301 Renal Transplant Study Group ERL B 302 Renal Transplant Study Group. Enteric-coated mycophenolate sodium: Results of two pivotal global multicenter trials. Transplant Proc. 2001;33:3241–3244
  26. Branten AJ, du Buf-Vereijken PW, Vervloet M, Wetzels JF. Mycophenolate mofetil in idiopathic membranous nephropathy: A clinical trial with comparison to a historic control group treated with cyclophosphamide. Am J Kidney Dis. 2007;50:248–256
  27. Chan TM, Lin AW, Tang SCW, et al. Prospective controlled study on mycophenolate mofetil and prednisolone in the treatment of membranous nephropathy with nephrotic syndrome. Nephrology (Carlton). 2007;12:576–581

 Originally published online as doi:10.1053/j.ajkd.2008.04.013 on June 26, 2008.

 Trial registration: www.cochrane-renal.org/dbsearch.php; study number CRG020800132.

PII: S0272-6386(08)00827-5

doi: 10.1053/j.ajkd.2008.04.013

American Journal of Kidney Diseases
Volume 52, Issue 4 , Pages 699-705 , October 2008

Article Tools

* Image Usage & Resolution