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Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials

  • Authors:
    • Jian‑Nan Zheng
    • Tong‑Dan Bi
    • Lin‑Bo Zhu
    • Lin‑Lin Liu

  • View Affiliations

  • Published online on: July 6, 2018     https://doi.org/10.3892/etm.2018.6418
  • Pages: 1882-1890

  • Copyright : © Zheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

The efficacy and safety of mycophenolate mofetil (MMF) for immunoglobulin A nephropathy (IgAN) remains debatable. Therefore, the present meta‑analysis was conducted with randomized controlled trials (RCTs). PubMed/MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were analyzed to identify eligible trials. The pooled risk ratio (RR) with 95% confidence interval (CI) was estimated for all the dichotomous outcome measures. A total of eight RCTs with nine publications (n=510 patients) were included. No significant difference was noted between therapeutic regimens with and without MMF for renal remission and end stage renal disease (ESRD) of patients with IgAN (seven trials; RR, 1.250; 95% CI, 0.993‑1.574; P=0.057; and four trials; RR, 0.728; 95% CI, 0.164‑3.236; P=0.676). To further define the effects of MMF for renal remission, subgroup analysis was performed, demonstrating that MMF was significantly more effective compared with the placebo (three trials; RR, 2.152; 95% CI, 1.198‑3.867; P=0.010), although the immunosuppressive regimens with MMF had no significantly different effects compared with those without MMF (four trials; RR, 1.140; 95% CI, 0.955‑1.361; P=0.146), indicating that MMF was superior to placebo and had a similar efficacy to other immunosuppressants for renal remission. In addition, subgroup analysis for ESRD revealed no significant differences between MMF and placebo and between the immunosuppressive regimens with and without MMF (three trials; RR, 0.957; 95% CI, 0.160‑5.726; P=0.962; and one trial; RR, 0.205; 95% CI, 0.010‑4.200; P=0.303). Furthermore, there were no significant differences between the therapeutic regimens with and without MMF in terms of the risk of adverse events. The present meta‑analysis demonstrated that MMF was more effective compared with the placebo, may have similar efficacy to other immunosuppressants in terms of inducing renal remission of IgAN and may not increase the risk of adverse events. The long‑term effects of MMF on the prognosis of patients with IgAN require verification in further studies.
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September-2018
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Spandidos Publications style
Zheng JN, Bi TD, Zhu LB and Liu LL: Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials. Exp Ther Med 16: 1882-1890, 2018.
APA
Zheng, J., Bi, T., Zhu, L., & Liu, L. (2018). Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials. Experimental and Therapeutic Medicine, 16, 1882-1890. https://doi.org/10.3892/etm.2018.6418
MLA
Zheng, J., Bi, T., Zhu, L., Liu, L."Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16.3 (2018): 1882-1890.
Chicago
Zheng, J., Bi, T., Zhu, L., Liu, L."Efficacy and safety of mycophenolate mofetil for IgA nephropathy: An updated meta‑analysis of randomized controlled trials". Experimental and Therapeutic Medicine 16, no. 3 (2018): 1882-1890. https://doi.org/10.3892/etm.2018.6418