Mycophenolate mofetil for the treatment of systemic lupus erythematosus: an open pilot trial

Objective: To investigate the effectiveness and safety of mycophenolate mofetil in patients with systemic lupus erythematosus who were inadequately controlled with corticosteroids, antimalarials, and other immunosuppresive agents.; Methods: Ten patients with systemic lupus erythematosus (SLE) were treated with 1500-2000 mg mycophenolae mofetil (MMF) daily for a median observation time of 11.2 +/- 2.4 (8-16) months in an open clinical trial. The effectiveness and safety of treatment were analyzed using an established disease activity score, clinical status, and laboratory parameters. Results: All patients improved under treatment with no or only minor side effects. The disease activity score (SLAM) decreased statistically significantly from a median of 15.6 +/- 5.5 to 9.9 +/- 4.1 after three months (P < 0.01) and to 8.0 +/- 3.3 after six months (P < 0.01). Hematologic parameters did nor change significantly whereas a reduction of inflammatory markers was observed. Four patients with SLE-nephritis already treated with cyclophosphamide pulse therapy continuously showed a slight improvement of renal function. Prednisolone dosages could be reduced significantly from a median level of 10.0 +/- 5.1 mg/d before treatment to 4.6 +/- 3.5 mg/d after six months (P < 0.01). Conclusion: Mycophenolate mofetil is a promising option in immunosuppressive treatment of patients with moderate and severe systemic lupus erythematosus who did not show a satisfactory response to other immunosuppressives.