Mycophenolate Mofetil Superior to Azathioprine as Maintenance Therapy for Lupus Nephritis

For decades, initial treatment of patients with nephritis associated with systemic lupus erythematosus has been a relatively high-dose cyclophosphamide regimen developed by the NIH. More recently, data have suggested that induction regimens of low-dose cyclophosphamide, oral mycophenolate mofetil (MMF; CellCept), or azathioprine are as effective as the NIH regimen. The preferred agent for maintenance therapy also has been unclear; in studies as recent as 2010, researchers were unable to distinguish a difference between azathioprine and MMF.

In this manufacturer-funded study, 227 patients with lupus nephritis who had responded to induction therapy were randomized to maintenance therapy with MMF or azathioprine for 36 months. Primary endpoints…