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Abstract: TH-PO360

Mycophenolate Mofetil vs. Cyclophosphamide as Induction Treatment and Mortality in a Series of Cases from the Colombian Caribbean Region with Lupus Nephritis

Session Information

Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

  • 1800 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

Authors

  • Peña-Vargas, William Arturo, Universidad Simón Bolívar, Barranquilla, Colombia
  • Aroca Martinez, Gustavo, Universidad Simon Bolivar / Clinica de la Costa, Barranquilla, Colombia
  • Gonzalez Torres, Henry J., Universidad Simon Bolivar, Barranquilla, Colombia
  • Cadena, Andres, Universidad Simón Bolívar, Barranquilla, Colombia
Background

Lupus nephritis (LN) is the most severe complication of systemic lupus erythematosus and induction therapy defines the prognosis of the disease. The type of immunosuppressive therapy (Mycophenolate Mofetil; MMF and Cyclophosphamide; CP) is chosen according to clinical and histological criteria. The objetive was to assessing response to induction therapy with MMF vs CFM and mortality in a number of cases from the Colombian Caribbean region with LN.

Methods

A retrospective analytical study. 423 patients with diagnosis of LN between 2008-2018 were included. Two regimens of immunosuppressive therapy for induction were evaluated in LN: MMF (n = 331); (Dose 2 g / day for 6 months) vs CP (n = 92) (500 mg IV every 15 days for 3 months). Patients were classified according to the criteria of clinical response of ACR (American College of Rheumatology) at: Complete remission (CR), partial remission (PR) and no remission (NR). Furthermore, the mortality associated with MMF vs CFM to 500 weeks (9 years) by Kaplan-Meier estimator was calculated.

Results

All patients, 87% were women, the mean age was 36 ± 13 years. The most common clinical presentation was nephrotic syndrome (70%). Histological class was predominantly proliferative class IV (66%), followed by Class III (23%). Statistically significant proteinuria in 24 hours and creatinine in both treatment groups (MMF vs CFM) (p <0.05) difference was found. Regarding the response to induction therapy, 225 (49%) cases NR, 123 (29%) were made and RC 91 (22%) RP. CFM mortality rate (68%) VS MMF (30). There were no statistically significant differences in clinical response and mortality among patient groups, as well as the values of C3, C4 and anti-dsDNA.

Conclusion

In our population, the clinical response in the induction and the mortality rate is similar between the two treatment groups (MMF vs CFM), although the MMF was superior in terms of averages, in response and decreased mortality, but this does not he reached for a statistical difference.