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In patients with lupus nephritis on maintenance therapy, is there additional benefit in utilizing 2 grams vs 3 grams of mycophenolate mofetil (MMF) daily?

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What is your approach to dosing MMF in maintenance therapy for lupus nephritis?

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3 Answers
Mednet Member
Mednet MemberInvited Expert
Rheumatology · Uniformed Services University of the Health Sciences (USUHS)
Answered on

I agree with @Dr. First Last's answer.

A few nuances to add:

  • In my patients of African Ancestry, I always start with 1.5 gm bid if tolerated as they tend to need a higher dose (probably related to lower enterohepatic circulation, more rapid mycophenolic acid clearance, and other metabolic mechanism...

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Mednet Member
Mednet MemberInvited Expert
Rheumatology · NYU Langone Health
Answered on · Updated on

Agree generally with Drs. @Dr. First Last and @Dr. First Last with following caveats. First, MMF is used for both induction of remission and maintenance of remission. I too observe that patients of Asian ancestry have high renal CR even at 2 gm a day while patients of African American often demonstr...

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Mednet Member
Mednet MemberInvited Expert
Rheumatology · MUSC Health
Answered on

This is an interesting question. My take on it would be if the patient's renal disease activity is well controlled on 2g a day I would stay at that dose. Black lupus nephritis patients often need the higher dose of 3g per day and is the dose I use to treat LN in Black patients. I maintain them on 3g...

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