Mycophenolate mofetil prevents the development of a clinical relapse in SLE patients at risk: an open pilot study

  • M Bijl1,

    Affiliated with

    • G Horst1,

      Affiliated with

      • H Bootsma1,

        Affiliated with

        • PC Limburg1 and

          Affiliated with

          • CGM Kallenberg1

            Affiliated with

            Arthritis Res20024(Suppl 1):104

            DOI: 10.1186/ar439

            Received: 15 January 2002

            Published: 4 February 2002

            Background

            Systemic lupus erythematosus (SLE) is characterised by the presence of antibodies to double-stranded DNA (dsDNA). These antibodies are supposedly involved in the pathogenesis of SLE. Eighty percent of patients develop a clinical relapse within 10 weeks after a significant rise in anti-dsDNA level. This can be prevented by the administration of corticosteroids at the time of rise in anti-dsDNA. We hypothesise that administration of mofetil mycophenolate (MMF) will have similar effects without the side effects of corticosteroids.

            Methods

            SLE patients (n = 36) were followed monthly for a rise in levels of anti-dsDNA, defined as exceeding 125% of the level of the previous sample, and amounting at least 15 E/ml within a 4-month period. At the time of a rise patients started with 2000 mg MMF daily for a period of 6 months. Patients were monitored monthly for the occurrence of a clinical relapse and to assess serological activity and state of activation of CD4+, CD8+ and CD19+ lymphocyte subsets.

            Results

            In 10 patients a serological relapse was encountered. All patients started MMF and completed a 6 months study period without the occurrence of a clinical relapse. Side effects were minimal. Antibodies to dsDNA decreased during the study period (P < 0.001) associated with a decrease in activation of CD19+ lymphocytes. No difference in the state of activation of CD4+ or CD8+ lymphocyte subsets could be demonstrated.

            Conclusion

            Administration of MMF after a rise of antibodies to dsDNA prevents the occurrence of clinical relapses of SLE and is well tolerated.

            Authors’ Affiliations

            (1)
            Academic Hospital Groningen

            Copyright

            © BioMed Central Ltd 2002

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