Comparison of the efficacy and safety of mycophenolate mofetil combined with leflunomide or tacrolimus induction in the treatment of lupus nephritis
Objective To evaluate the efficacy and safety of mycophenolate mofetil(MMF)in combination with either leflunomide(LEF)or tacrolimus(TAC)as induction therapy for lupus nephritis(LN).Methods Patients with refractory LN who did not respond to monotherapy with MMF or cyclo-phosphamide(CYC)were selected for switching to combination therapy with MMF(1 g/d)plus either LEF(20 mg/d)or TAC(2 mg/d).The remission rates,laboratory parameters,and adverse reactions were compared between the two groups.Results A total of 278 patients with LN were included,and 38 patients(19 in each group)were selected for analysis.The results showed that:(1)In terms of achie-ving remission in LN,at 3 months,there were 7 cases(36.84%)in the MMF+LEF group and 10 cases(52.63%)in the MMF+TAC group;at 6 months,there were 10 cases(52.63%)in the MMF+LEF group and 14 cases(73.68%)in the MMF+TAC group.However,the differences in remission rates be-tween the two groups at 3 months and 6 months were not statistically significant(all P>0.05).(2)After 6 months of treatment,there were statistically significant differences in complement C3,C4,blood urea nitrogen,albumin,IgA,IgM,and urine total protein/creatinine ratio between the two groups(all P<0.05).However,there were no statistically significant differences between the two groups at 3 months and 6 months(all P>0.05).(3)There were no significant differences in adverse reactions between the two groups(P>0.05).Conclusions Both the combination of MMF and LEF,as well as the combination of MMF and TAC,significantly improved the condition of LN.There were no significant differences in re-mission rates and safety between the two combinations.