PMID- 31523631
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2220-6124 (Print)
IS  - 2220-6124 (Electronic)
IS  - 2220-6124 (Linking)
VI  - 8
IP  - 4
DP  - 2019 Aug 21
TI  - The role of mycophenolate in the treatment of antineutrophil cytoplasmic 
      antibody-associated vasculitis.
PG  - 75-82
LID - 10.5527/wjn.v8.i4.75 [doi]
AB  - Mycophenolic acid, the active metabolite for mycophenolate mofetil and 
      mycophenolic sodium, is a strong, noncompetitive, reversible inhibitor of inosine 
      monophosphate dehydrogenase, the key enzyme in de novo synthesis of guanosine 
      nucleotides leading to selective inhibition of lymphocyte proliferation. 
      Mycophenolic acid has been evaluated as induction and remission maintenance agent 
      in the treatment of antineutrophil cytoplasmic antibody-associated vasculitis 
      (AAV). Since the course of disease of AAV usually requires long term 
      immunosuppression, mycophenolate has been explored as a less toxic agent compared 
      to cyclophosphamide and azathioprine. Mycophenolate is a potent immunosuppressive 
      agent in the therapy of AAV, non-inferior to other available drugs with 
      comparable side effect profile. Therefore, it could be a valuable alternative in 
      cases of toxicity with life threatening side effects or intolerance to 
      cyclophosphamide or azathioprine, in cases with high cumulative dose of 
      cyclophosphamide, but also in cases with insufficient response. Several studies 
      have shown a higher relapse rate following discontinuation of mycophenolate or in 
      mycophenolate treated subjects that raises concerns about its usefulness in the 
      treatment of AAV. This review describes the efficacy of mycophenolate in AAV as 
      remission induction agent, as remission maintenance agent, and as therapeutic 
      option in relapsing AAV disease, the relapse rate following discontinuation of 
      mycophenolate, and the adverse events related to mycophenolate treatment.
FAU - Koukoulaki, Maria
AU  - Koukoulaki M
AD  - Center for Nephrology "G. Papadakis", General Hospital of Nikaia - Piraeus "Agios 
      Panteleimon", Piraeus, Nikaia 18454, Greece, mkoukoulaki@gmail.com.
FAU - Iatrou, Christos
AU  - Iatrou C
AD  - Center for Nephrology "G. Papadakis", General Hospital of Nikaia - Piraeus "Agios 
      Panteleimon", Piraeus, Nikaia 18454, Greece.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - World J Nephrol
JT  - World journal of nephrology
JID - 101610229
PMC - PMC6715575
OTO - NOTNLM
OT  - Antineutrophil cytoplasmic antibody-associated vasculitis
OT  - Granulomatosis with polyangiitis
OT  - Induction
OT  - Microscopic polyangiitis
OT  - Mycophenolate mofetil
OT  - Mycophenolate sodium
OT  - Mycophenolic acid
OT  - Relapse
OT  - Remission
COIS- Conflict-of-interest statement: The authors declare that they have no conflict of 
      interest.
EDAT- 2019/09/17 06:00
MHDA- 2019/09/17 06:01
PMCR- 2019/08/21
CRDT- 2019/09/17 06:00
PHST- 2019/03/04 00:00 [received]
PHST- 2019/07/09 00:00 [revised]
PHST- 2019/07/16 00:00 [accepted]
PHST- 2019/09/17 06:00 [entrez]
PHST- 2019/09/17 06:00 [pubmed]
PHST- 2019/09/17 06:01 [medline]
PHST- 2019/08/21 00:00 [pmc-release]
AID - 10.5527/wjn.v8.i4.75 [doi]
PST - ppublish
SO  - World J Nephrol. 2019 Aug 21;8(4):75-82. doi: 10.5527/wjn.v8.i4.75.