Get More Information About CellCept On Treating Kidney Failure
2019-03-05 14:10
When we encounter refractory nephropathy, hormone effect is not obvious, we often use immunosuppressive agents to suppress kidney inflammation and reduce urinary protein. Today I'm going to talk about an immunosuppressive agent, mycophenolate mofetil (the generic name is very twisted, usually used to call the commercial name, CellCept).
What is mycophenolate ester? What's the usage?
In 1995, mycophenolate mofetil came out and quickly became a "red man" in nephrology.
Cyclophosphamide was commonly used in nephrology (now also commonly used) because of its remarkable effect in the treatment of refractory nephropathy. However, cyclophosphamide is a cytotoxic drug, with adverse reactions such as hematotoxicity, gonadal toxicity, bladder toxicity, hyponatremia and increased cancer risk. The most troubling thing is gonadal toxicity, which can not be used for a long time. When accumulated to a certain dose, it will become infertile and menopausal, affecting fertility. Young people are very resistant to it.
Mycophenolate mofetil has no gonadal toxicity, and is effective in treating nephropathy and reducing urinary protein. For example, in the treatment of lupus nephritis, early studies have shown that mycophenolate mofetil overwhelms commonly used drugs when lupus nephritis has kidney disease. When it first came into being, it became a "magic drug" in the Department of Rheumatology and nephrology.
However, the shortcomings of mycophenolate mofetil were exposed after a long time of use.
One is the side effect. The first is its immunosuppressive effect, which may cause a variety of infection problems, including a creepy Pneumocystis carinii infection, although only a very small number of people will occur, but the mortality rate is very high. It may also cause adverse reactions such as anemia, nausea, abdominal pain, tumors (low incidence of conventional dosage). It seems that besides the absence of gonadal toxicity, side effects are not as good as cyclophosphamide.
Secondly, after a large number of experimental studies, we found that the effect of mycophenolate mofetil on lupus nephropathy is not much different from cyclophosphamide, and the data comparison has no statistical significance.
Thirdly, it is much more expensive than cyclophosphamide.
After calming down, now experts in the field of nephropathy regard mycophenolate ester more rationally: the effect is worth affirming, but the apparent efficiency is not as outstanding as previously imagined, side effects also need to be considered, correct use has a certain use.
What kinds of nephropathy can mycophenolate mofetil treat?
1. Type III or IV lupus nephritis.
Lupus mostly occurs in women of childbearing age. This group has reproductive needs, so cyclophosphamide can not be used for a long time. Therefore, when the cumulative amount of cyclophosphamide is approaching the damage of ovaries, mycophenolate mofetil can be used instead to continue to improve the condition.
2. Focal segmental glomerulosclerosis
Mycophenolate mofetil can be used in patients with focal segmental glomerulosclerosis who are unwilling to use, who cannot use calmodulin inhibitors such as hormones and/or cyclosporine, or when the efficacy is poor and side effects are serious.
3. Membranous proliferative nephropathy
This is a very difficult nephropathy, and there are few effective drugs for it. When hormones, cyclophosphamide and cyclosporine do not work, mycophenolate mofetil can be used as an alternative.
4. IgA nephropathy with poor pathology and manifestation of massive proteinuria
When mycophenolate mofetil is needed, the kidney disease is often serious and many drugs are ineffective.
There are two points to note when using mycophenolate mofetil:
First, to prevent infection, after all, the immunity will decline after the use of drugs, and live vaccines can not be injected (excluding cold vaccines, influenza vaccines and pneumococcal vaccines are inactivated).
Second, contraception, if you intend to conceive, from six weeks before pregnancy to breast-feeding can not use mycophenolate mofetil ester, it may lead to abortion and fetal malformation.
At present, mycophenolate mofetil is seldom used as the preferred drug in nephrology, but it still occupies an important place. When the refractory nephropathy can not be solved by hormones and other drugs, mycophenolate mofetil may relieve patients'pain.
E-mail: kidney-treatment@hotmail.com
- Tag: Treating Kidney Failure CellCept
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