Mycophenolate Mofetil in Induction and Maintenance Therapy for Juvenile Onset Severe Lupus Nephritis

The study evaluated the efficacy of mycophenolate mofetil (MMF) in treating juvenile onset severe lupus nephritis. Twelve children (mean age 12.6 years) underwent 6 months of induction therapy with MMF and prednisolone, resulting in significant improvements in urine protein, serum anti-double-stranded DNA antibody, renal function, albumin, and serum C3 and C4 levels (p < 0.05). Ten children continued with 18 months of maintenance therapy, during which no renal flares occurred, and the mean prednisolone dose was reduced to 9.2 mg/day. Among 5 patients who had a second biopsy, 4 showed significant histological improvement. Major infections were reported in 5 patients, including Herpes zoster, bacteremia, and hair loss. MMF was concluded to be an effective therapy for this condition.