Enteric-coated mycophenolate sodium in pediatric lupus nephritis: a retrospective cohort study

Background: The objective of this study was to examine the long-term efficacy and complications associated with use of enteric-coated mycophenolate sodium (EC-MPS) for treatment of pediatric lupus nephritis (LN). Methods: This was a retrospective analysis of pediatric patients treated between 1995 and 2008. Comparisons were made between patients with LN who were and were not treated with EC-MPS (MPS and non-MPS groups). The primary endpoint was survival. The secondary endpoint was time to stage 3 chronic kidney disease (CKD). Response rates, laboratory parameters, and complications were determined. Results: There were 33 patients in the MPS group and 19 patients in the non-MPS group. The MPS group had more patients with complete/partial response (72.7 vs. 31.6 %; P < 0.001) and a significantly higher survival rate (0.0 vs. 42.1 %, P < 0.001), but the groups had similar rates of stage 3 CKD. The rebound of complement 3 was more rapid in the MPS group. There were no significant between-group differences in the incidence of complications, including gastrointestinal complications. Conclusion: A limitation of this study is the heterogeneity in the timing of treatment and in the duration of follow-up. Nonetheless, our findings suggest that EC-MPS can be an effective treatment for pediatric LN.