Clinical Outcomes and Safety of Mycophenolate Mofetil in Patients with Lupus Nephritis: A Cross-Sectional Study

Abstract

Background: Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE) associated with significant morbidity and risk of renal failure. Mycophenolate mofetil (MMF) is widely used as a maintenance therapy; however, real-world data on its effectiveness and safety remain essential for optimizing patient outcomes. Objective: To evaluate the clinical outcomes, remission rates, and safety profile of MMF in adult patients with biopsyproven lupus nephritis. Methods: This cross-sectional study included 100 adult LN patients attending the Mansoura Urology and Nephrology Center between July 2024 and July 2025. All patients had class III or IV LN and received MMF-based therapy. Clinical, laboratory, and histopathological data were collected. Patients were categorized into complete remission, partial remission, or relapse based on standard criteria. Results: The mean age was 37.66 ± 9.50 years, with a predominance of females (93%). Hypertension was present in 65% of patients, and 54% had prior acute kidney injury. Class IV LN was the most frequent histopathological subtype (70%). At assessment, 40% achieved complete remission, 30% partial remission, and 30% experienced relapse. Proteinuria significantly improved from a median of 3.7 g/day at presentation to 0.75 g/day at follow-up, with stable renal function. MMF was well tolerated, with 80% of patients reporting no adverse events; serious infections occurred in 12%. Conclusions: MMF demonstrates favorable efficacy and safety in the management of lupus nephritis, with substantial remission rates and acceptable adverse effects. Continuous monitoring is essential to manage relapses and complications.