DOI: 10.36347/sasjm.2021.v07i02.006

Pages: 50-56

1. Introduction: Despite showing varying degree of prevalence rate with geographical variations, IgA nephropathy (IgAN) remains a leading cause for glomerular disease worldwide. Being an auto immune disease, using oral prednisolone for six months has been in practice for long. This paper aims to evaluate the efficacy and safety of mycophenolate mofetil combined with low dose prednisolone versus standard dose of prednisolone in the treatment of IgA nephropathy. Methodology: This was an open label randomized clinical trial conducted for one year during 2018-19 among newly diagnosed 53 adult patients with IgA nephropathy from department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. After enrollment of the study respondents were randomized into two groups and one group was given MMF orally with a dose of 1500 mg/day for consecutive 6 months with Prednisolone 0.5 mg/kg/day for 2 months and then tapered by 0.1mg/kg/day each month for next 4 months. Another group was given 6 months regimen of oral prednisolone starting with 1.0 mg/kg/day for 2 months and then reduced by 0.2 mg/kg/day per month for the next 4 months. Patients were monitored at baseline and at subsequent intervals. At the end of 6th month, all the patients were evaluated for outcome measures and adverse effects of the medications. Results and discussion: In group A 38.46% patients had complete remission, 42.31% had partial remission and 19.23% had no remission. In group B, 40.74% had complete remission, 40.74% had partial remission and 18.52% had no remission. No statistically significant difference in remission rate between two groups were found. In regards to potential adverse effects, some variations between the groups have been observed; most frequent adverse effect in group A was infection (23%). In group B most frequent adverse effect observed was Cushing’s syndrome (33%). Conclusion: Mycophenolate mofetil and low-dose prednisone combined therapy can be considered a reasona