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Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review

BACKGROUND: IgA nephropathy is the most common primary glomerular disease worldwide and also the most frequent cause of kidney failure. Mycophenolate mofetil (MMF) is a selective immunosuppressant widely used in many autoimmune diseases. However, the benefits and risks of MMF for the treatment of Ig...

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Autores principales: Chen, Youyuan, Li, YuMin, Yang, ShengLin, Li, Yan, Liang, Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267433/
https://www.ncbi.nlm.nih.gov/pubmed/25475967
http://dx.doi.org/10.1186/1471-2369-15-193
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author Chen, Youyuan
Li, YuMin
Yang, ShengLin
Li, Yan
Liang, Min
author_facet Chen, Youyuan
Li, YuMin
Yang, ShengLin
Li, Yan
Liang, Min
author_sort Chen, Youyuan
collection PubMed
description BACKGROUND: IgA nephropathy is the most common primary glomerular disease worldwide and also the most frequent cause of kidney failure. Mycophenolate mofetil (MMF) is a selective immunosuppressant widely used in many autoimmune diseases. However, the benefits and risks of MMF for the treatment of IgA nephropathy remain uncertain. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to assess the efficacy and safety of MMF in IgA nephropathy patients, using the statistical software Review Manager 5.1. RESULTS: Eight RCTs involving 357 patients were identified and included in this review. Overall, no statistical difference was found in the therapeutic effect of MMF treatment compared with other therapies. MMF had no significant effects on reducing proteinuria or protecting renal function. However, subgroup analysis indicated that relatively short-term therapy (<18 months) might be beneficial in IgA nephropathy patients while longer term MMF use conferred no advantage. There was also no statistical difference between MMF and control groups in the incidence of side effects. When compared with other immunosuppressants, MMF was considered superior to cyclophosphamide in terms of better therapeutic effects and fewer adverse reactions, but no difference was found between MMF and leflunomide. CONCLUSIONS: Our current evidence indicates that a relatively short course of MMF may be beneficial in treating IgA nephropathy. However, high-quality RCTs with large sample size as well as a well-designed study to evaluate the long-term effects of MMF are needed to further evaluate the efficacy and safety of MMF in this disease. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2369-15-193) contains supplementary material, which is available to authorized users.
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spelling pubmed-42674332014-12-17 Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review Chen, Youyuan Li, YuMin Yang, ShengLin Li, Yan Liang, Min BMC Nephrol Research Article BACKGROUND: IgA nephropathy is the most common primary glomerular disease worldwide and also the most frequent cause of kidney failure. Mycophenolate mofetil (MMF) is a selective immunosuppressant widely used in many autoimmune diseases. However, the benefits and risks of MMF for the treatment of IgA nephropathy remain uncertain. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to assess the efficacy and safety of MMF in IgA nephropathy patients, using the statistical software Review Manager 5.1. RESULTS: Eight RCTs involving 357 patients were identified and included in this review. Overall, no statistical difference was found in the therapeutic effect of MMF treatment compared with other therapies. MMF had no significant effects on reducing proteinuria or protecting renal function. However, subgroup analysis indicated that relatively short-term therapy (<18 months) might be beneficial in IgA nephropathy patients while longer term MMF use conferred no advantage. There was also no statistical difference between MMF and control groups in the incidence of side effects. When compared with other immunosuppressants, MMF was considered superior to cyclophosphamide in terms of better therapeutic effects and fewer adverse reactions, but no difference was found between MMF and leflunomide. CONCLUSIONS: Our current evidence indicates that a relatively short course of MMF may be beneficial in treating IgA nephropathy. However, high-quality RCTs with large sample size as well as a well-designed study to evaluate the long-term effects of MMF are needed to further evaluate the efficacy and safety of MMF in this disease. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2369-15-193) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-05 /pmc/articles/PMC4267433/ /pubmed/25475967 http://dx.doi.org/10.1186/1471-2369-15-193 Text en © Chen et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Chen, Youyuan
Li, YuMin
Yang, ShengLin
Li, Yan
Liang, Min
Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review
title Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review
title_full Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review
title_fullStr Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review
title_full_unstemmed Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review
title_short Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: a systematic review
title_sort efficacy and safety of mycophenolate mofetil treatment in iga nephropathy: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267433/
https://www.ncbi.nlm.nih.gov/pubmed/25475967
http://dx.doi.org/10.1186/1471-2369-15-193
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