Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
September-2018 Volume 16 Issue 3

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
September-2018 Volume 16 Issue 3

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article Open Access

Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials

  • Authors:
    • Jian‑Nan Zheng
    • Tong‑Dan Bi
    • Lin‑Bo Zhu
    • Lin‑Lin Liu
  • View Affiliations / Copyright

    Affiliations: Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
    Copyright: © Zheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Pages: 1882-1890
    |
    Published online on: July 6, 2018
       https://doi.org/10.3892/etm.2018.6418
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

The efficacy and safety of mycophenolate mofetil (MMF) for immunoglobulin A nephropathy (IgAN) remains debatable. Therefore, the present meta‑analysis was conducted with randomized controlled trials (RCTs). PubMed/MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were analyzed to identify eligible trials. The pooled risk ratio (RR) with 95% confidence interval (CI) was estimated for all the dichotomous outcome measures. A total of eight RCTs with nine publications (n=510 patients) were included. No significant difference was noted between therapeutic regimens with and without MMF for renal remission and end stage renal disease (ESRD) of patients with IgAN (seven trials; RR, 1.250; 95% CI, 0.993‑1.574; P=0.057; and four trials; RR, 0.728; 95% CI, 0.164‑3.236; P=0.676). To further define the effects of MMF for renal remission, subgroup analysis was performed, demonstrating that MMF was significantly more effective compared with the placebo (three trials; RR, 2.152; 95% CI, 1.198‑3.867; P=0.010), although the immunosuppressive regimens with MMF had no significantly different effects compared with those without MMF (four trials; RR, 1.140; 95% CI, 0.955‑1.361; P=0.146), indicating that MMF was superior to placebo and had a similar efficacy to other immunosuppressants for renal remission. In addition, subgroup analysis for ESRD revealed no significant differences between MMF and placebo and between the immunosuppressive regimens with and without MMF (three trials; RR, 0.957; 95% CI, 0.160‑5.726; P=0.962; and one trial; RR, 0.205; 95% CI, 0.010‑4.200; P=0.303). Furthermore, there were no significant differences between the therapeutic regimens with and without MMF in terms of the risk of adverse events. The present meta‑analysis demonstrated that MMF was more effective compared with the placebo, may have similar efficacy to other immunosuppressants in terms of inducing renal remission of IgAN and may not increase the risk of adverse events. The long‑term effects of MMF on the prognosis of patients with IgAN require verification in further studies.
View Figures

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

View References

1 

Wyatt RJ and Julian BA: IgA Nephropathy. N Engl J Med. 368:2402–2414. 2013. View Article : Google Scholar : PubMed/NCBI

2 

O'Shaughnessy MM, Hogan SL, Thompson BD, Coppo R, Fogo AB and Jennette JC: Glomerular disease frequencies by race, sex and region: Results from the international kidney biopsy survey. Nephrol Dial Transplant. Jul 2–2017.(Epub ahead of print).

3 

Moriyama T, Tanaka K, Iwasaki C, Oshima Y, Ochi A, Kataoka H, Itabashi M, Takei T, Uchida K and Nitta K: Prognosis in IgA nephropathy: 30-year analysis of 1,012 patients at a single center in Japan. PLoS One. 9:e917562014. View Article : Google Scholar : PubMed/NCBI

4 

Rasche FM, Keller F, Rasche WG, Schiekofer S, Boldt A, Sack U and Fahnert J: Why, when and how should immunosuppressive therapy considered in patients with immunoglobulin A nephropathy? Clin Exp Immunol. 186:115–133. 2016. View Article : Google Scholar : PubMed/NCBI

5 

Jonsson CA and Carlsten H: Mycophenolic acid inhibits inosine 5′-monophophate dehydrogenase and suppresses immunoglobulin and cytokine production of B cells. Int Immunopharmacol. 3:31–37. 2003. View Article : Google Scholar : PubMed/NCBI

6 

Allison AC and Eugui EM: Mycophenolate mofetil and its mechanisms of action. Immunopharmacology. 47:85–118. 2000. View Article : Google Scholar : PubMed/NCBI

7 

Lee SH, Kim CD, Huh KH, Cho BH, Ju MK, Lee DR, Cho HR, Park JW, Lee JJ, Lee S, et al: Low-dose mycophenolate mofetil in tablet form or capsule form combined with tacrolimus in the early period after kidney transplantation: A prospective randomized trial. Clin Nephrol. 86:319–327. 2016. View Article : Google Scholar : PubMed/NCBI

8 

Glander P, Hambach P, Braun KP, Fritsche L, Waiser J, Mai I, Neumayer HH and Budde K: Effect of mycophenolate mofetil on IMP dehydrogenase after the first dose and after long-term treatment in renal transplant recipients. Int J Clin Pharmacol Ther. 41:470–476. 2003. View Article : Google Scholar : PubMed/NCBI

9 

Hou JH, Le WB, Chen N, Wang WM, Liu ZS, Liu D, Chen JH, Tian J, Fu P, Hu ZX, et al: Mycophenolate mofetil combined with prednisone versus full-dose prednisone in IgA nephropathy with active proliferative lesions: A randomized controlled trial. Am J Kidney Dis. 69:788–795. 2017. View Article : Google Scholar : PubMed/NCBI

10 

Hogg RJ, Bay RC, Jennette JC, Sibley R, Kumar S, Fervenza FC, Appel G, Cattran D, Fischer D, Hurley RM, et al: Randomized controlled trial of mycophenolate mofetil in children, adolescents, and adults with IgA nephropathy. Am J Kidney Dis. 66:783–791. 2015. View Article : Google Scholar : PubMed/NCBI

11 

Liu X, Dewei D, Sun S, Xu G, Liu H, He L and Zhang P: Treatment of severe IgA nephropathy: Mycophenolate mofetil/prednisone compared to cyclophosphamide/prednisone. Int J Clin Pharmacol Ther. 52:95–102. 2014. View Article : Google Scholar : PubMed/NCBI

12 

Liu XW, Li DM, Xu GS and Sun SR: Comparison of the therapeutic effects of leflunomide and mycophenolate mofetil in the treatment of immunoglobulin A nephropathy manifesting with nephrotic syndrome. Int J Clin Pharmacol Ther. 48:509–513. 2010. View Article : Google Scholar : PubMed/NCBI

13 

Tang SC, Tang AW, Wong SS, Leung JC, Ho YW and Lai KN: Long-term study of mycophenolate mofetil treatment in IgA nephropathy. Kidney Int. 77:543–549. 2010. View Article : Google Scholar : PubMed/NCBI

14 

Tang S, Leung JC, Chan LY, Lui YH, Tang CS, Kan CH, Ho YW and Lai KN: Mycophenolate mofetil alleviates persistent proteinuria in IgA nephropathy. Kidney Int. 68:802–812. 2005. View Article : Google Scholar : PubMed/NCBI

15 

Frisch G, Lin J, Rosenstock J, Markowitz G, D'Agati V, Radhakrishnan J, Preddie D, Crew J, Valeri A and Appel G: Mycophenolate mofetil (MMF) vs placebo in patients with moderately advanced IgA nephropathy: A double-blind randomized controlled trial. Nephrol Dial Transplant. 20:2139–2145. 2005. View Article : Google Scholar : PubMed/NCBI

16 

Maes BD, Oyen R, Claes K, Evenepoel P, Kuypers D, Vanwalleghem J, Van Damme B and Vanrenterghem YF: Mycophenolate mofetil in IgA nephropathy: Results of a 3-year prospective placebo-controlled randomized study. Kidney Int. 65:1842–1849. 2004. View Article : Google Scholar : PubMed/NCBI

17 

Chen X, Chen P, Cai G, Wu J, Cui Y, Zhang Y, Liu S and Tang L: A randomized control trial of mycophenolate mofeil treatment in severe IgA nephropathy. Zhonghua Yi Xue Za Zhi. 82:796–801. 2002.(In Chinese). PubMed/NCBI

18 

Du B, Jia Y, Zhou W, Min X, Miao L and Cui W: Efficacy and safety of mycophenolate mofetil in patients with IgA nephropathy: An update meta-analysis. BMC Nephrol. 18:2452017. View Article : Google Scholar : PubMed/NCBI

19 

Vecchio M, Bonerba B, Palmer SC, Craig JC, Ruospo M, Samuels JA, Molony DA, Schena FP and Strippoli GF: Immunosuppressive agents for treating IgA nephropathy. Cochrane Database Syst Rev. 2015:CD0039652015.

20 

Chen Y, Li Y, Yang S, Li Y and Liang M: Efficacy and safety of mycophenolate mofetil treatment in IgA nephropathy: A systematic review. BMC Nephrol. 15:1932014. View Article : Google Scholar : PubMed/NCBI

21 

Xu G, Tu W, Jiang D and Xu C: Mycophenolate mofetil treatment for IgA nephropathy: A meta-analysis. Am J Nephrol. 29:362–367. 2009. View Article : Google Scholar : PubMed/NCBI

22 

Higgins JP and Green S: Cochrane handbook for systematic reviews of interventions. version 5.1.0. The Cochrane Collaboration. 2011.http://handbook.cochrane.orgUpdated March 2011.

23 

Knobloch K, Yoon U and Vogt PM: Preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and publication bias. J Craniomaxillofac Surg. 39:91–92. 2011. View Article : Google Scholar : PubMed/NCBI

24 

Deierhoi MH, Kauffman RS, Hudson SL, Barber WH, Curtis JJ, Julian BA, Gaston RS, Laskow DA and Diethelm AG: Experience with mycophenolate mofetil (RS61443) in renal transplantation at a single center. Ann Surg. 217:476–484. 1993. View Article : Google Scholar : PubMed/NCBI

25 

Rovin BH: Lupus nephritis: Guidelines for lupus nephritis-more recommendations than data? Nat Rev Nephrol. 8:620–621. 2012. View Article : Google Scholar : PubMed/NCBI

26 

Conti F, Ceccarelli F, Perricone C, Massaro L, Cipriano E, Pacucci VA, Truglia S, Miranda F, Morello F, Alessandri C, et al: Mycophenolate mofetil in systemic lupus erythematosus: Results from a retrospective study in a large monocentric cohort and review of the literature. Immunol Res. 60:270–276. 2014. View Article : Google Scholar : PubMed/NCBI

27 

Langman LJ, LeGatt DF, Halloran PF and Yatscoff RW: Pharmacodynamic assessment of mycophenolic acid-induced immunosuppression in renaltransplant recipients. Transplantation. 62:666–672. 1996. View Article : Google Scholar : PubMed/NCBI

28 

Park JS, Kim GH, Jo CH, Kim S, Lee CH, Kim YS and Kang CM: Effect of mycophenolic acid on cyclosporin A-induced fibronectin expression in rat mesangial cells. Pharmacology. 91:20–28. 2013. View Article : Google Scholar : PubMed/NCBI

29 

Dubus I, Vendrely B, Christophe I, Labouyrie JP, Delmas Y, Bonnet J and Combe C: Mycophenolic acid antagonizes the activation of cultured human mesangial cells. Kidney Int. 62:857–867. 2002. View Article : Google Scholar : PubMed/NCBI

30 

Hauser IA, Renders L, Radeke HH, Sterzel RB and Goppelt-Struebe M: Mycophenolate mofetil inhibits rat and human mesangial cell proliferation by guanosine depletion. Nephrol Dial Transplant. 14:58–63. 1999. View Article : Google Scholar : PubMed/NCBI

31 

Al Hussain T, Hussein MH, Al Mana H and Akhtar M: Pathophysiology of IgA Nephropathy. Adv Anat Pathol. 24:56–62. 2017. View Article : Google Scholar : PubMed/NCBI

32 

Lai KN: Pathogenesis of IgA nephropathy. Nat Rev Nephrol. 8:275–283. 2012. View Article : Google Scholar : PubMed/NCBI

33 

Beckwith H, Medjeral-Thomas N, Galliford J, Griffith M, Levy J, Lightstone L, Palmer A, Roufosse C, Pusey C, Cook HT and Cairns T: Nephrol Dial Transplant. 32 Suppl 1:i123–i128. 2017. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Zheng JN, Bi TD, Zhu LB and Liu LL: Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials. Exp Ther Med 16: 1882-1890, 2018.
APA
Zheng, J., Bi, T., Zhu, L., & Liu, L. (2018). Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials. Experimental and Therapeutic Medicine, 16, 1882-1890. https://doi.org/10.3892/etm.2018.6418
MLA
Zheng, J., Bi, T., Zhu, L., Liu, L."Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16.3 (2018): 1882-1890.
Chicago
Zheng, J., Bi, T., Zhu, L., Liu, L."Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16, no. 3 (2018): 1882-1890. https://doi.org/10.3892/etm.2018.6418
Copy and paste a formatted citation
x
Spandidos Publications style
Zheng JN, Bi TD, Zhu LB and Liu LL: Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials. Exp Ther Med 16: 1882-1890, 2018.
APA
Zheng, J., Bi, T., Zhu, L., & Liu, L. (2018). Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials. Experimental and Therapeutic Medicine, 16, 1882-1890. https://doi.org/10.3892/etm.2018.6418
MLA
Zheng, J., Bi, T., Zhu, L., Liu, L."Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16.3 (2018): 1882-1890.
Chicago
Zheng, J., Bi, T., Zhu, L., Liu, L."Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16, no. 3 (2018): 1882-1890. https://doi.org/10.3892/etm.2018.6418
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team