PMID- 17179175
OWN - NLM
STAT- MEDLINE
DCOM- 20070619
LR  - 20240316
IS  - 0003-4967 (Print)
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 66
IP  - 6
DP  - 2007 Jun
TI  - Induction of remission in active anti-neutrophil cytoplasmic antibody-associated 
      vasculitis with mycophenolate mofetil in patients who cannot be treated with 
      cyclophosphamide.
PG  - 798-802
AB  - BACKGROUND: Active anti-neutrophil cytoplasmic antibody-associated vasculitis 
      (AAV) is commonly treated with cyclophosphamide, a drug with serious side 
      effects, and with corticosteroids. OBJECTIVE: To determine the efficacy of a 
      possible alternative drug for cyclophosphamide, oral mycophenolate mofetil (MMF) 
      1000 mg twice daily and oral prednisolone 1 mg/kg once daily as remission 
      induction treatment. METHODS: 32 consecutive patients with 34 episodes of active 
      vasculitis who could not be treated with cyclophosphamide were diagnosed for a 
      median (range) of 6.0 (0.3-22) years and experienced 4 (0-14) relapses prior to 
      the current episode. Treatment response and relapse-free survival were analysed. 
      RESULTS: Complete remission (CR) was obtained in 25 (78%) patients, partial 
      remission (PR) in 6 (19%), whereas 1 (3%) patient did not respond. 19 patients 
      relapsed, 13 (52%) after CR, 14 (3-58) months after starting the treatment and 6 
      (100%) after PR, 6 (2-10) months after starting the treatment. The median 
      relapse-free survival was 16 months, comparable with the interval between the 
      previous relapse and the current MMF-treated relapse (17 (3-134) months). 
      Relapse-free survival at 1, 3, and 5 years was 63%, 38% and 27%, respectively. 
      Patients who had been treated successfully with cyclophosphamide before responded 
      better (CR 84%, relapse 50%) than those who had not (CR 50%, relapse 100%). Minor 
      gastrointestinal side effects and infections occurred frequently. MMF was 
      prematurely discontinued due to adverse effects in two patients. CONCLUSION: MMF, 
      in combination with prednisolone, can induce remission in patients with relapses 
      of AAV intolerant to cyclophosphamide.
FAU - Stassen, Patricia M
AU  - Stassen PM
AD  - Department of Nephrology, University Medical Center Groningen, PO Box 30001, 9700 
      RB Groningen, The Netherlands. p.m.stassen@int.umcg.nl
FAU - Tervaert, Jan Willem Cohen
AU  - Tervaert JW
FAU - Stegeman, Coen A
AU  - Stegeman CA
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Review
DEP - 20061219
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - 9PHQ9Y1OLM (Prednisolone)
RN  - HU9DX48N0T (Mycophenolic Acid)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Antineutrophil Cytoplasmic/*blood
MH  - Autoimmune Diseases/*drug therapy/immunology
MH  - Contraindications
MH  - Cyclophosphamide
MH  - Disease-Free Survival
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Mycophenolic Acid/*analogs & derivatives/therapeutic use
MH  - Prednisolone/therapeutic use
MH  - Recurrence
MH  - Remission Induction
MH  - Treatment Outcome
MH  - Vasculitis/*drug therapy/immunology
PMC - PMC1954648
COIS- Competing interests: None.
EDAT- 2006/12/21 09:00
MHDA- 2007/06/20 09:00
PMCR- 2010/06/01
CRDT- 2006/12/21 09:00
PHST- 2006/12/21 09:00 [pubmed]
PHST- 2007/06/20 09:00 [medline]
PHST- 2006/12/21 09:00 [entrez]
PHST- 2010/06/01 00:00 [pmc-release]
AID - ard.2006.060301 [pii]
AID - ar60301 [pii]
AID - 10.1136/ard.2006.060301 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2007 Jun;66(6):798-802. doi: 10.1136/ard.2006.060301. Epub 2006 
      Dec 19.