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Myocophenolate mofetil in the treatment of systemic lupus erythematosus


Authors: R. Svobodová;  M. Sokalská Jurkiewicz;  J. Hořínková
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 21, 2013, No. 3, p. 140-146.
Category: Review and Case Report

Overview

Systemic lupus erythematosus is a systemic autoimmune disease with multiple organ manifestations and serologic abnormalities. The spectrum of clinical manifestations is wide, varying from mild symptoms to potentially lethal conditions with irreversible organ damage. Organ involvement determines the morbidity and mortality of patients and the type of therapy. The most common involvement includes lupus nephritis, which occurs in 15–60% of patients, and leads to chronic renal failure in up to 47% of patients. Currently, a two-stage treatment of lupus nephritis is recommended: an intensive induction phase to induce remission followed by the maintenance phase to maintain remission.

In a case report of a female patient with systemic lupus erythematosus with multiple organ involvement – (lupus nephritis, vasculitis, ocular and hematologic involvement, pericarditis) and high antibody activity (positive antinuclear antibodies, anti-dsDNA, anti-C1q, ANCA and anti-nucleosome antibodies), the issues of therapy associated with intolerance and adverse effects of standard treatment are discussed. In recent years, mycophenolate mofetil has been demonstrated to play a significant role in the treatment of lupus nephritis in patients with systemic lupus erythematosus. In many cases mycophenolate mofetil can successfully replace the existing therapy.

Key words:
Systemic lupus erythematosus, lupus nephritis, mycophenolate mofetil


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