Analysis Of The Efficacy And Safety Of Mycophenolate Mofetil In The Treatment Of Systemic Lupus Erythematosus

Objective:To investigate the effectiveness and safety of mycophenolate mofetil combined with prednisone in the treatment of systemic lupus erythematosus(SLE).Methods:With keywords:mycophenolate mofetil,induction therapy,systemic lupus erythematosus,cyclophosphamide,azathioprine,safety,effectiveness and other keywords,in CNKI,Pubmed,Wanfang,Weipu,China Bio Relevant literature searches are carried out in literature databases,Web of Science,Cochrane Library,ClinicalTrials and other Chinese and foreign databases.To compare the clinical outcome and safety of mycophenolate mofetil and cyclophosphamide in the induction treatment of lupus nephritis and the clinical outcome and safety of mycophenolate mofetil and azathioprine in the remission treatment of lupus nephritis.The main outcome of induction therapy includes 24h urine protein quantification(UTP),serum creatinine level(Scr)and complete remission(CR).The secondary outcome is adverse reactions(ADR)including infection,leukopenia,and gastrointestinal symptoms such as diarrhea and nausea.And vomiting;The main outcomes of remission treatment include serum creatinine levels(Scr),complete remission(CR)and partial remission(PR).Secondary outcomes include renal failure,recurrence,and death.ADR includes infection,leukopenia,and gastrointestinal symptoms such as diarrhea,nausea,and vomiting.A collection of 60 patients with systemic lupus erythematosus admitted to the Department of Rheumatology and Immunology,Nanfang Hospital,Southern Medical University from 2019.1-2020.11 for a single-center retrospective study.There were 30 cases in the experimental group and 30 cases in the control group.The treatment plan for the experimental group was mycophenolate mofetil(MMF),the control group was cyclophosphamide(CYC);both groups were combined with prednisone.After 24 weeks of treatment,the indicators of the two groups were compared to compare the efficacy and safety of mycophenolate mofetil and cyclophosphamide regimens.The main curative effect index is the disease activity score,and the secondary curative effect index is autoantibody quantification,serum complement and immunoglobulin levels.Safety indicators include hematuria,liver and kidney function,inflammation indicators,blood lipids and blood sugar,and coagulation function.Results:In the meta-analysis,induction therapy included 609 patients in six randomized clinical trials,and remission therapy included 475 patients in five randomized clinical trials.In the induction treatment of lupus patients,mycophenolate mofetil has no obvious advantage over cyclophosphamide in terms of efficacy indicators,but mycophenolate mofetil is more effective than cyclophosphamide in achieving complete remission of patients.There is little difference between the two in improving patients’ blood creatinine levels,and cyclophosphamide has a better effect on reducing urine protein.In addition,compared with cyclophosphamide,mycophenolate mofetil can significantly reduce the incidence of adverse reactions,including leukopenia,menstrual disorders and gastrointestinal symptoms.Unfortunately,the two groups did not show obvious advantages in terms of secondary infections;and in remission treatment,mycophenolate mofetil also did not show obvious advantages in curative effect,but compared with azathioprine,Mycophenolate mofetil can significantly reduce the probability of relapse in patients undergoing remission treatment.In the same remission treatment,mycophenolate mofetil can effectively reduce the incidence of leukopenia and menstrual disorders,but there is no significant difference between the two groups in terms of infection and gastrointestinal symptoms.A total of 60 patients with SLE were included in the retrospective study.They were divided into 30 cases in the MMF experimental group and 30 cases in the CYC control group in chronological order.After 24 weeks of treatment,the disease activity and serum IgM levels in both groups were significantly improved(P<0.05).The patients in the control group improved their urine protein quantification and complement C3 and C4 levels at 24 hours after treatment(P<0.05).The serum IgG and Sm antibody levels of the experimental group decreased after treatment(P<0.05).There was no significant difference in efficacy indicators between the two groups after treatment,but the average daily dose of prednisone[control group 20.67±12.96);experimental group 13.83±12.91)],the experimental group had a lesser trend(P=0.57).Compared with the control group,serum creatinine、urea、platelets、INR and APTT indexes of the experimental group were lower(P<0.05).Conclusion:1.In terms of clinical outcome in the induction treatment of lupus nephritis,mycophenolate mofetil has a higher complete remission rate than cyclophosphamide,but there is no statistically significant difference in the improvement of serum creatinine between the two,and cyclophosphamide The effect of reducing urine protein is better.In terms of safety,the incidence of adverse reactions of mycophenolate mofetil is significantly lower,including leukopenia,menstrual disorders and gastrointestinal symptoms,but the two groups have no secondary infections.obvious difference.2.In the clinical outcome of remission treatment,mycophenolate mofetil has no obvious advantage over azathioprine,but mycophenolate mofetil can significantly reduce the probability of relapse in patients undergoing remission therapy.In terms of safety,mycophenolate mofetil can effectively reduce the incidence of leukopenia and menstrual disorders,but there is no significant difference between the two groups in terms of infection and gastrointestinal symptoms.3.Retrospective analysis confirms that in the treatment of SLE,mycophenolate mofetil can effectively reduce the disease activity of patients,and the consumption of hormones tends to be less.In terms of safety,the risk of renal damage in patients is compared with that of cyclophosphate.