Efficacy And Adverse Events Of Mycophenolate Mofetil Versus Cyclophosphamide For Treatment Of Lupus Nephritis:a Meta-Analysis Of Randomised Controlled Trials

Objective SLE is a chronic autoimmune disease, and lupus nephritis is a high risk factor that influences the morbidity and mortality of SLE.The treatment of LN is an important concern of renal physician. We performed this meta-analysis of randomised controlled trials to compare the efficacy and adverse events of MMF versus CYC.Method We searched the pubmed,embase and the cochrane controlled trials registerdatabases up to December 2014for relevant randomised controlled trials. The Jadad scale was used toassess the quality of the included studies. Data concerning the study design, patientcharacteristics, therapy and outcomes were extracted. The risk ratio (RR) and mean difference (MD) were calculated and pooled using fixed or random effects models.Results This paper included seven RCTs with a total of 701 patients. These RCTs were weighed 2-3 scores by Jadad scale. MMF is superior to intravenous CYC therapy in CR rate(RR:1.72,P=0.006) and rising the content of serum complement C4(MD:3.33 mg/d1,P=0.03).MMF has lower rates of amenorrhea,infection and alopecia than CYC(RR:0.29, P=0.004; RR:0.82, P=0.04; RR:0.28, P<0.00001,respectively).The rate of diarrhea is higher in MMF than CYC (RR:2.38; P<0.00001) Other indexes like Scr or proteinuria are almost the same in the two drugs.Conclusion MMF is non-inferiority compared with CYC in the efficacy of treatment of LN, and it’s superior to CYC in CR rate and rising the content of serum complement C4. The CI seems to rise slower in MMF than that in CYC.But whether MMF is safer than CYC is not sure yet.