Mycophenolate Mofetil In Refractory Nephrotic Syndrome

ObjectiveStudies on the treatment of nephrotic syndrome with Mycophenolate Mofetil were reported frequently, but the effect of Mycophenolate Mofetil varied from one report to another because of the different study criteria and conditions. In order to determine whether Mycophenolate Mofetil is effective in the treatment of refractory nephrotic syndrome, a meta-analysis of clinical trials on the treatment of nephrotic syndrome with Mycophenolate Mofetil from 1970 to 2000 was conducted.MethodsPublished papers on randomized, controlled and prospective clinical trials were identified from Chinese Biomedical LiteratureDatabase (from 1979 to 2006), Weipu Periodical Database(from 1994 to 2006), Qinghua Periodical Database(from 1989 to 2006),Cochrane library,EBM online (2005.4), PubMed(from 1966 to 2005), NGC(from 1998 to 2005) and CRDD (from 1995 to 2005) with the subject headings "Mycophenolate Mofetil & Nephrotic syndrome", and the similar papers listed in the references of above papers were also included. All the identified papers were analyzed with the meta-analysis of weight percentage. The statistical analysis was based on the effective rate of Mycophenolate Mofetil treatment, which included the percentage of the complete remission and the partial remission of refractory nephrotic syndrome. ResultsThe effective rate of the mycophenolate mofetil and prednisone combined treatment group (83.24%) was significantly higher than that of the cyclophosphamide and prednisone combined treatment group (64.2%, P<0.05). The mycophenolate mofetil combined with prednisone and cyclophosphamine treatment was more effective than the cyclophosphamide combined with prednisone treatment. The effective rate was 85.7% and 65%, respectively (P<0.05). And the incidence of side effect in mycophenolate mofetil treatment was significantly lowerthan in cyclophosphamide treatment with respect of leucocyte reduction, liver lesion , complaint of stomach intestine and secondary infection ( P <0105). ConclusionMycophenolate mofetil is effective in the treatment of refractory nephritic syndrome, and the incidence of side effect in mycophenolate mofetil treatment was significantly lower than in cyclophosphamide treatment.