Abstract: FR-PO0876
Long-Term Outcome of Lupus Nephritis in Patients Treated with Cellcept (MMF)- vs. Cyclophosphamide (CYP)-Based Regimens
Session Information
- Glomerular Outcomes: From Proteinuria to Prognosis
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Alquaiz, Rawan, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
- Alsulaim, Abdullah Saleh, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
- Albulayhid, Ghadah, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
- Alshahrani, Manal Abdullah, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
- Alshuqaybi, Hassan M, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
- Elfar, Ahmed F., King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
- Mohamed, Gamal, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh Province, Saudi Arabia
Background
Lupus nephritis (LN) remains a significant cause of morbidity and progression to end-stage renal disease. While CYP and MMF are established induction therapies, their long-term comparative outcomes, especially in the Saudi population are limited.
Methods
This retrospective cohort study analyzed 121 biopsy-proven proliferative LN patients at King Faisal Specialist Hospital & Research Centre between 2011–2023. Patients were grouped based on induction therapy: CYP vs MMF. Primary outcome was response rates (complete, partial, no response) at 6 months, 1, 3, and 5 years. This response was defined according to KDIGO guidelines.
Results
The cohort was predominantly female (87.6%), with Class IV LN being most common (41.3%). 55.9% received CYP and 44.1% received MMF. Complete remission at 6 months was 56%, and 80% at 5 years. Complete remission rates was better for CYP at 1 year (P= 0.04), but this effect disappeared at 5 years (P=0.6). Relapse rates were 3% at 6 months, 8.7% at 1 year, 8.6% at 3 years, and 8.8% at 5 years. Both therapies demonstrated sustained remission and low relapse over five years
Conclusion
Both CYP and MMF are effective induction therapies for LN, with sustained remission and low relapse rates over five years. Long-term renal survival appears comparable, supporting MMF as a safe, long-term maintenance option.
Remission rates CYP VS MMF
| Duration | Induction agents | Complete Remission | Partial Remission | No response | |
| 6 months | CYP MMF | 24 (48.9%) 24 (64.8%) | 20 (40.8%) 7 (18.9%) P = 0.03 | 5 (10.2%) 6 (16.2%) | |
| 1 year | CYP MMF | 28 (56%) 29 (76.3%) P =0.04 | 16 (32%) 6 (15.7%) | 6 (12%) 3 (7.8%) | |
| 5 years | CYP MMF | 32 (78%) 20 (83.3%) P=0.6 | 6 (14.6%) 3 (12.5%) | 3 (7.3%) 1 (4.1%) | |
P: P Value