Objective: The EULAR recommendations underline the use of MMF for Lupus Nephritis (LN) but also for the treatment of moderate/severe non-renal manifestations (NLN). This study aims at evaluating the 5-years drug retention rate (DRR) of MMF in a SLE cohort in a real-life scenario. Secondly, we investigated the MMF influence to control chronic damage progression. Methods: We performed a longitudinal study including all the SLE patients starting MMF in our Lupus Clinic (from 2008 to 2020). The DRR was estimated using the Kaplan-Meier method. Results: We evaluated 162 SLE patients (M/F 22/140). The most frequent indications for prescribing MMF were LN (101 patients, 62.3%) and musculoskeletal manifestations (39, 24.1%) followed by NPSLE (10, 6.2%) and other manifestations (12, 7.4%). We registered a median treatment duration of 30 months (IQR 55). At 60 months follow-up we observed a DRR of 61.1% for LN patients, which was similar to that registered for patients without renal involvement (60.5%). The DRR was higher in the subgroup of patients with joint involvement (75.4%, p non-significant). During the overall observation period, 92 patients (59.2%) discontinued MMF. The main cause of withdrawal was the achievement of remission, observed in 20 patients (21.7%). Moreover, MMF resulted able to control chronic damage progression, as demonstrated by the lack of significant increase in the median SDI values (baseline: 0.6, IQR 1; last: 0.93, IQR 1). Conclusions: Our finding suggested that MMF is a safe and effective drug for SLE manifestation other than LN, especially for joint involvement. Moreover, it was able to reduce the chronic damage progression.

Five-years drug survival of mycophenolate mofetil therapy in patients with systemic lupus erythematosus. comparison between renal and non-renal involvement / Olivieri, Giulio; Ceccarelli, Fulvia; Natalucci, Francesco; Pirone, Carmelo; Orefice, Valeria; Pacucci, Viviana Antonella; Garufi, Cristina; Truglia, Simona; Spinelli, Francesca Romana; Alessandri, Cristiano; Conti, Fabrizio. - In: JOINT BONE SPINE. - ISSN 1297-319X. - 88:6(2021). [10.1016/j.jbspin.2021.105246]

Five-years drug survival of mycophenolate mofetil therapy in patients with systemic lupus erythematosus. comparison between renal and non-renal involvement

Giulio Olivieri
Primo
;
Fulvia Ceccarelli
;
Francesco Natalucci;Carmelo Pirone;Valeria Orefice;Viviana Antonella Pacucci;Cristina Garufi;Simona Truglia;Francesca Romana Spinelli;Cristiano Alessandri;Fabrizio Conti
2021

Abstract

Objective: The EULAR recommendations underline the use of MMF for Lupus Nephritis (LN) but also for the treatment of moderate/severe non-renal manifestations (NLN). This study aims at evaluating the 5-years drug retention rate (DRR) of MMF in a SLE cohort in a real-life scenario. Secondly, we investigated the MMF influence to control chronic damage progression. Methods: We performed a longitudinal study including all the SLE patients starting MMF in our Lupus Clinic (from 2008 to 2020). The DRR was estimated using the Kaplan-Meier method. Results: We evaluated 162 SLE patients (M/F 22/140). The most frequent indications for prescribing MMF were LN (101 patients, 62.3%) and musculoskeletal manifestations (39, 24.1%) followed by NPSLE (10, 6.2%) and other manifestations (12, 7.4%). We registered a median treatment duration of 30 months (IQR 55). At 60 months follow-up we observed a DRR of 61.1% for LN patients, which was similar to that registered for patients without renal involvement (60.5%). The DRR was higher in the subgroup of patients with joint involvement (75.4%, p non-significant). During the overall observation period, 92 patients (59.2%) discontinued MMF. The main cause of withdrawal was the achievement of remission, observed in 20 patients (21.7%). Moreover, MMF resulted able to control chronic damage progression, as demonstrated by the lack of significant increase in the median SDI values (baseline: 0.6, IQR 1; last: 0.93, IQR 1). Conclusions: Our finding suggested that MMF is a safe and effective drug for SLE manifestation other than LN, especially for joint involvement. Moreover, it was able to reduce the chronic damage progression.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1561653
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