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ACR 2019 | Daily Highlights
Lupus nephritis
LONG-TERM OUTCOME OF A RANDOMIZED CONTROLLED TRIAL COMPARING TACROLIMUS WITH MYCOPHENOLATE MOFETIL AS INDUCTION THERAPY OF SEVERE LUPUS NEPHRITIS
Abstract: 859
Authors: C.C. Mok al.
Key content:
Seventy six patients with active lupus nephritis were randomized to induction therapy consisting of prednisolone plus either concomitant mycophenolate mofetil (MMF, 2-3g/day) or tacrolimus (TAC, 1-0.06mg/kg/day). Complete renal (CR) or good partial renal responders were switched to azathioprine (AZA, 2mg/kg/day) for maintenance.
The rate of CR at 6 months was 59% in MMF and 62% in the TAC group. The cumulative risk of renal ?ares in patients treated with MMF/AZA was 28% at 3 years, 42% at 5 years and 58% at 10 years, in those treated with TAC/AZA flares were observed in 32% at 3 years, 53% in 5 years and 66% in 10 years (p=0.43).
Relevance:
The 10 year data of this RCT showed that TAC remained non-inferior to MMF as induction therapy of lupus nephritis in terms of renal flares, renal function decline and mortality. These data suggest that tacrolimus may be an alternative to MMF for LN induction therapy, for example in women with urgent pregnancy plans.
Zusammenfassung und Kommentar von:
Prof. Dr. Ulrich Walker
Basel
