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2017 ; 18
(1
): 245
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Efficacy and safety of mycophenolate mofetil in patients with IgA nephropathy: an
update meta-analysis
#MMPMID28724421
Du B
; Jia Y
; Zhou W
; Min X
; Miao L
; Cui W
BMC Nephrol
2017[Jul]; 18
(1
): 245
PMID28724421
show ga
BACKGROUND: The application of mycophenolate mofetil (MMF) in treating patients
with immunoglobulin A nephropathy (IgAN) remains uncertain. This update
meta-analysis was performed to re-evaluate the therapeutic potential of MMF in
IgAN. METHODS: Articles were obtained by searching the electronic databases
without language restriction. Randomized controlled trials studying the role of
MMF in treating IgAN were collected. The quality of included studies was
critically evaluated. Data analyses were performed by using RevMan 5.3 software.
RESULTS: A total of 297 articles were screened and eight articles were finally
included. Among the eight randomized controlled trials, five and three were high
quality and low quality, respectively. Both fixed-effect and random-effect model
were used. Pooled results by combining all the eight studies suggested that IgAN
patients in MMF group had a higher remission rate than that in control group.
Compared to placebo or corticosteroid monotherapy, MMF monotherapy exerted a
higher remission rate and side effect rate in both main analysis and subgroup
analysis by human race. Compared to corticosteroid plus other immunosuppressive
agent therapy, corticosteroid plus MMF therapy had a higher remission rate, lower
serum creatinine doubling rate, progression to end-stage renal disease rate and
side effects rate. Subgroup analysis by therapeutic regimen further confirmed
these results between corticosteroid plus MMF therapy and corticosteroid plus
cyclophosphamide therapy. Funnel-plot displayed a symmetrical figure, indicating
no publication bias existed. CONCLUSIONS: MMF has the potential in treatment of
IgAN, especially for Asians. The evidence currently available shows that MMF
monotherapy has a more efficacy but higher side effects when compared to placebo
or corticosteroid monotherapy in treatment of Asians with IgAN. While MMF
combined with corticosteroid regimen has a more efficacy and lower side effects
when compared with corticosteroid plus cyclophosphamide regimen.
|Antibiotics, Antitubercular/adverse effects/therapeutic use
[MESH]