Mycophenolate Mofetil Versus Cyclophosphamide for the Induction of Remission in Nonlife-Threatening Relapses of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: Randomized, Controlled Trial.

摘要: Background and objectives Cyclophosphamide has been the mainstay of treatment ANCA-associated vasculitis. However, cyclophosphamide unfavorable side effects alternatives are needed. Evidence suggests that mycophenolate mofetil can induce sustained remission in nonlife-threatening disease. The purpose this study was to compare efficacy safety versus for induction relapses proteinase 3-ANCA– myeloperoxidase-ANCA–associated Design, setting, participants, & measurements We conducted a multicenter randomized, controlled trial. Participants with first or second relapse vasculitis were randomized both combination glucocorticoids. Maintenance therapy consisted azathioprine arms. Primary outcome at 6 months, secondary outcomes included disease-free survival 2 4 years. Results Eighty-four participants enrolled, whom 41 received 43 cyclophosphamide. Eighty-nine percent 3-ANCA positive. At 27 (66%) mofetil–treated 35 (81%) cyclophosphamide-treated (P=0.11). Disease-free rates years 61% 39% cyclophosphamide, respectively, 43% 32% mofetil, respectively (at years, log rank test, P=0.17). Conclusions did not demonstrate be similarly effective as inducing relapsed might an alternative selected patients relapses.