A Johns Hopkins evaluation of a drug commonly used to prevent rejection of kidney transplants has found that it also may help patients with severe symptoms of kidney disease.
After taking the immunosuppressive drug mycophenolate mofetil (MMF) for a few months, some patients showed dramatic improvement even when the dosage of their traditional steroid medications was reduced. Others were able to discontinue steroids entirely.
MMF improved patient conditions without the negative side effects associated with steroids, such as acne, weight gain and cataracts, and without the toxicities associated with other drugs.
Results from this treatment are published in the February issue of the American Journal of Kidney Diseases, a publication of the National Kidney Foundation.
"This report documents a novel application of this drug to treat kidney diseases complicated by fluid retention and early loss of kidney function," says William A. Briggs, M.D., lead author of the study and an associate professor of medicine. "MMF shows considerable promise, especially for patients who are having problems with steroids. It was well-tolerated with no evidence of serious toxicity, and patients taken off steroids did not relapse while taking MMF."
Physicians evaluated treatment responses in eight patients with various diseases of the glomerulus, a network of blood capillaries in the kidney that filters waste products from the blood. Patients took the MMF pills twice a day for an average of six months. MMF was started in conjunction with steroids, but several patients were later treated with MMF alone.
MMF treatment significantly reduced the amount of protein leaking from the kidneys, relieving the discomfort from moderate to severe fluid retention and correcting very high cholesterol levels in some patients. Protein leaks, a common problem in patients with glomerular disease, cause swelling in the legs or throughout the body.
"Clearly, it's been very effective," Briggs says. "MMF can work with lower doses of steroids to control protein leaks and it sometimes can work alone, avoiding prolonged exposure to steroids and other drugs."
The traditional treatments for glomerular disease include steroids given alone or together with cyclosporine or cytotoxic drugs. Despite the effectiveness of these medications, Briggs says, some patients cannot tolerate steroids for long periods, suffer serious toxicities of cytotoxic drugs or even relapse when effective medications are withdrawn.
The report's other authors were Michael J. Choi, M.D., and Paul J. Scheel Jr., M.D.
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