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Mycophenolate-mofetil/prednisolone Rebound effect manifested as renal flare of lupus-nephritis: case report

In a prospective study (NCT02453997) of 88 patients, a patient [age and sex not stated] was described, who exhibited rebound effect manifested as renal flare of lupus-nephritis during treatment with mycophenolate-mofetil and prednisolone for lupus nephritis. The patient was diagnosed with lupus nephritis and started receiving prednisolone 0.8 mg/kg/day and mycophenolate-mofetil [routes not stated] 1g twice a day. Thereafter, the dose of prednisolone was gradually reduced to 7.5 mg/day at around 6 months and then 5-7.5 mg/day at 12 months. The dose of mycophenolate-mofetil was 1000mg twice a day for initial six months, 750mg twice a day from month 7 to month 12 and then 500-750mg twice a day in the second year. Subsequently, the patient had class III renal flare of the disease while receiving reduced doses of mycophenolate-mofetil and prednisolone. It was considered as rebound effect manifested as renal flare of lupus-nephritis secondary to inadequate drug exposure [duration of treatment to reaction onset and outcome not stated]. Yap DYH, et al. Pharmacokinetics and pharmacogenomics of mycophenolic acid and its clinical correlations in maintenance immunosuppression for lupus nephritis. Nephrology Dialysis Transplantation 35: 810-818, No. 5, May 2020. Available from: URL: http://doi.org/10.1093/ndt/gfy284

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Reactions 5 Sep 2020 No. 1820