TY - JOUR
T1 - Comparative efficacy and safety of mycophenolate mofetil versus cyclophosphamide in patients with active antineutrophil cytoplasmic antibody-associated vasculitis
T2 - a meta-analysis of randomized trials
AU - Song, G. G.
AU - Lee, Y. H.
N1 - Funding Information:
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2020, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
PY - 2021/6
Y1 - 2021/6
N2 - Objective: This study aimed to assess the efficacy and safety of mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) in patients with active antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods: We performed a meta-analysis of four randomized clinical trials (RCTs; 300 patients) to examine the relative efficacy and safety of MMF compared to CYC in patients with active AAV. Results: There was no significant difference in remission at 6 months between MMF and CYC (odds ratio [OR] 1.311, 95% confidence interval [CI] 0.570–3.017, P = 0.524). Additionally, the relapse rate did not differ between the MMF and CYC groups (OR 1.331, 95% CI 0.497–3.568, P = 0.570). There was no significant difference in serious adverse event (SAE; OR 1.232, 95% CI 0.754–2.014, P = 0.404) and infection rates (OR 0.958, 95% CI 0.561–1.634, P = 0.873) between the MMF and CYC groups. Some heterogeneity was found in the meta-analysis of remission and relapse rates (I2 = 57.4%, 63.4%), but no between-study heterogeneity was found during the meta-analysis of SAE and infection rate. Egger’s regression test showed no evidence of publication bias (Egger’s regression test P-values >0.1). Conclusion: MMF was an equally effective alternative treatment to CYC and MMF was comparable to CYC in patients with active AAV in terms of safety, suggesting that MMF can be used as an alternative to CYC for remission induction in AAV.
AB - Objective: This study aimed to assess the efficacy and safety of mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) in patients with active antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods: We performed a meta-analysis of four randomized clinical trials (RCTs; 300 patients) to examine the relative efficacy and safety of MMF compared to CYC in patients with active AAV. Results: There was no significant difference in remission at 6 months between MMF and CYC (odds ratio [OR] 1.311, 95% confidence interval [CI] 0.570–3.017, P = 0.524). Additionally, the relapse rate did not differ between the MMF and CYC groups (OR 1.331, 95% CI 0.497–3.568, P = 0.570). There was no significant difference in serious adverse event (SAE; OR 1.232, 95% CI 0.754–2.014, P = 0.404) and infection rates (OR 0.958, 95% CI 0.561–1.634, P = 0.873) between the MMF and CYC groups. Some heterogeneity was found in the meta-analysis of remission and relapse rates (I2 = 57.4%, 63.4%), but no between-study heterogeneity was found during the meta-analysis of SAE and infection rate. Egger’s regression test showed no evidence of publication bias (Egger’s regression test P-values >0.1). Conclusion: MMF was an equally effective alternative treatment to CYC and MMF was comparable to CYC in patients with active AAV in terms of safety, suggesting that MMF can be used as an alternative to CYC for remission induction in AAV.
KW - AAV
KW - CYC
KW - Efficacy
KW - MMF
KW - Safety
UR - http://www.scopus.com/inward/record.url?scp=85084143560&partnerID=8YFLogxK
U2 - 10.1007/s00393-020-00803-5
DO - 10.1007/s00393-020-00803-5
M3 - Article
C2 - 32337635
AN - SCOPUS:85084143560
SN - 0340-1855
VL - 80
SP - 425
EP - 431
JO - Zeitschrift fur Rheumatologie
JF - Zeitschrift fur Rheumatologie
IS - 5
ER -