Mycophenolate Mofetil Versus Intravenous Cyclophosphamide Pulses in the Treatment of Crescentic IgA Nephropathy
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A single-center random parallel study to compare the efficacy and safety of Mycophenolate mofetil versus intravenous Cyclophosphamide pulses in the treatment of crescentic IgA nephropathy
Condition or disease
Drug: Mycophenolate mofetil
IgA nephropathy is an immune-complex glomerulopathy that can result in capillary necrosis or extracapillary proliferation (crescents). Several studies have documented a higher incidence of hypertension and nephritic-range proteinuria in patients with the crescentic form of IgA nephropathy, suggesting that patients with this variant of the disease may have a worse prognosis. Some studies have shown that treatment with steroids and cyclophosphamide had efficacy on reducing proteinuria and preserving renal function by healing vasculitic lesions, therefore preventing the progression of glomerular sclerosis. Recent studies have also shown that mycophenolate mofetil is effective in the treatment of lupus nephritis with vasculitic lesion and small vasculitis with renal involvement. We will conduct a single-center prospective open-labeled clinical trial of 40 patients with crescentic IgA nephropathy and treat them randomly with pulse intravenous cyclophosphamide or oral mycophenolate mofetil. After 12 months of treatment, we will assess the efficacy, safety, tolerability and relapse of mycophenolate mofetil compared with cyclophosphamide in the treatment of crescentic IgA nephropathy.
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Ages Eligible for Study:
12 Years to 65 Years (Child, Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Patient with a diagnosis of IgAN without deposition of C4 and C1q, age 10-70y, sex free
Gross hematuria or an active urine sediment
Segmental necrotizing lesion of the capillary wall
Cellular or fibrocellular crescents ≥ 10%
Fibrinoid degeneration of small vessels
Fibrin positive Three or more items, with provision of criteria informed consent
More than four-week treatment with cytotoxic drug, such as CTX, CsA and MMF, prior to enrollment