@article {Stassen798, author = {Patricia M Stassen and Jan Willem Cohen Tervaert and Coen A Stegeman}, title = {Induction of remission in active anti-neutrophil cytoplasmic antibody-associated vasculitis with mycophenolate mofetil in patients who cannot be treated with cyclophosphamide}, volume = {66}, number = {6}, pages = {798--802}, year = {2007}, doi = {10.1136/ard.2006.060301}, publisher = {BMJ Publishing Group Ltd}, abstract = {Background: Active anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is commonly treated with cyclophosphamide, a drug with serious side effects, and with corticosteroids.Objective: To determine the efficacy of a possible alternative drug for cyclophosphamide, oral mycophenolate mofetil (MMF) 1000 mg twice daily and oral prednisolone 1 mg/kg once daily as remission induction treatment.Methods: 32 consecutive patients with 34 episodes of active vasculitis who could not be treated with cyclophosphamide were diagnosed for a median (range) of 6.0 (0.3{\textendash}22) years and experienced 4 (0{\textendash}14) relapses prior to the current episode. Treatment response and relapse-free survival were analysed.Results: Complete remission (CR) was obtained in 25 (78\%) patients, partial remission (PR) in 6 (19\%), whereas 1 (3\%) patient did not respond. 19 patients relapsed, 13 (52\%) after CR, 14 (3{\textendash}58) months after starting the treatment and 6 (100\%) after PR, 6 (2{\textendash}10) months after starting the treatment. The median relapse-free survival was 16 months, comparable with the interval between the previous relapse and the current MMF-treated relapse (17 (3{\textendash}134) months). Relapse-free survival at 1, 3, and 5 years was 63\%, 38\% and 27\%, respectively. Patients who had been treated successfully with cyclophosphamide before responded better (CR 84\%, relapse 50\%) than those who had not (CR 50\%, relapse 100\%). Minor gastrointestinal side effects and infections occurred frequently. MMF was prematurely discontinued due to adverse effects in two patients.Conclusion: MMF, in combination with prednisolone, can induce remission in patients with relapses of AAV intolerant to cyclophosphamide.}, issn = {0003-4967}, URL = {https://ard.bmj.com/content/66/6/798}, eprint = {https://ard.bmj.com/content/66/6/798.full.pdf}, journal = {Annals of the Rheumatic Diseases} }