Mycophenolate mofetil for systemic lupus erythematosus refractory to other immunosuppressive agents

Rheumatology (Oxford). 2002 Aug;41(8):876-82. doi: 10.1093/rheumatology/41.8.876.


Background: Mycophenolate mofetil (MMF) is an immunosuppressive drug widely used in solid organ transplantation, and it may play an increasing role in autoimmune disease. MMF has been introduced as a novel immunosuppressive agent in systemic lupus erythematosus (SLE), often in patients intolerant of or resistant to conventional immunosuppressive regimens.

Methods: We studied 21 patients with SLE, most of whom had previously received courses of cyclophosphamide therapy and had also received courses of azathioprine or methotrexate. Indications for treatment included uncontrolled disease activity and worsening renal involvement.

Results: MMF treatment resulted in reduced disease activity, as assessed by the SLEDAI (SLE disease activity index) (P=0.0001) and decreased proteinuria (P=0.027) while allowing a significant reduction in oral corticosteroid dose (P=0.0001). Levels of complement factors C3 and C4 and anti-double-stranded DNA antibodies were not significantly affected.

Conclusion: MMF appears to be a safe and effective alternative immunosuppressant for extra-renal and renal disease in SLE not responding to conventional immunosuppressive treatment.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antibodies, Antinuclear / blood
  • Azathioprine / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / immunology
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / therapeutic use*
  • Proteinuria / prevention & control
  • Racial Groups
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Failure


  • Antibodies, Antinuclear
  • Immunosuppressive Agents
  • Cyclophosphamide
  • Mycophenolic Acid
  • Azathioprine
  • Methotrexate