Efficacy And Safety Of Mycophenolate Mofetil For IgA Nephropathy An Updated Meta?analysis Of Randomized Controlled Trials

The efficacy and safety of mycophenolate mofetil(MMF)for IgAN remains debatable.Therefore,we conducted the present meta-analysis with randomized controlled trials(RCTs).We searched PubMed/MEDLINE,EMBASE and the Cochrane Central Register of Controlled Trials(CCRCT)for eligible trials.The searching time is from the establishment of the database to October 2017.The pooled risk ratio(RR)with 95% confidence interval(CI)was estimated for all the dichotomous outcome measures after determining the qualified test.Heterogeneity was assessed with the Cochran Q(heterogeneity chi-square),I2,and H statistics.Finally,eight RCTs with 9 publications(n = 510)were included.It showed no significant difference between therapeutic regimens with and without MMF for renal remission and ESRD of IgAN patients(7 trials,RR 1.250,95% CI 0.993-1.574,P = 0.057;4 trials,RR 0.728,95% CI 0.164-3.236,P = 0.676).Subgroup analysis for renal remission showed that MMF was superior to placebo significantly(3 trials,RR 2.152,95% CI 1.198-3.867,P = 0.010),but the immunosuppressive regimens with MMF had no significantly different effects with those without MMF(4 trials,RR 1.140,95% CI 0.955-1.361,P = 0.146);and subgroup analysis for ESRD found no significant differences between MMF and placebo and between the immunosuppressive regimens with MMF and without MMF(3 trials,RR 0.957,95% CI 0.160-5.726,P = 0.962;1 trial,RR 0.205,95% CI 0.010-4.200,P = 0.303).Besides,there were no significant differences between the therapeutic regimens with and without MMF for the risks of adverse events.In conclusion,the present meta-analysis showed that MMF was superior to placebo and might have similar efficacy with other immunosuppressants for inducing renal remission of IgAN.MMF might not add the risks of adverse events.The long-term effects of MMF on the prognosis of IgAN patients need to be verified in the further research.