Trial reportAnnals of the rheumatic diseases2010
Azathioprine versus mycophenolate mofetil for long-term immunosuppression in lupus nephritis: results from the MAINTAIN Nephritis Trial.
Trial report in Annals of the rheumatic diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 158 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
158 citing papers in PubMed, 8 syntheses or guidelines pooled it, 489 citations in OpenAlex.
- Saudi National Clinical Practice Guidelines for Management of Adult Systemic Lupus Erythematosus.Current rheumatology reviews · 2025Guideline
- II Brazilian Society of Rheumatology consensus for lupus nephritis diagnosis and treatment.Advances in rheumatology (London, England) · 2024Guideline
- Immunosuppressive treatment for proliferative lupus nephritis.The Cochrane database of systematic reviews · 2018Pooled it
- Comparative effectiveness of immunosuppressive drugs and corticosteroids for lupus nephritis: a systematic review and network meta-analysis.Systematic reviews · 2016Pooled it
- Safety and effectiveness of mycophenolate in systemic sclerosis. A systematic review.PloS one · 2015Pooled it
- [Statement on the use of mycophenolate mofetil for systemic lupus erythematosus].Zeitschrift fur Rheumatologie · 2013Guideline
- Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis.Annals of the rheumatic diseases · 2012Guideline
- American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis.Arthritis care & research · 2012Guideline
- Anifrolumab Dose Regimen Selection for a Phase 3 Trial in Lupus Nephritis.Clinical pharmacology and therapeutics · 2026Trial
- Mycophenolate Mofetil and New-Onset Systemic Lupus Erythematosus: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Leflunomide versus azathioprine for maintenance therapy of lupus nephritis: a prospective, multicentre, randomised trial and long-term follow-up.Annals of the rheumatic diseases · 2022Trial
- Weaning of maintenance immunosuppressive therapy in lupus nephritis (WIN-Lupus): results of a multicentre randomised controlled trial.Annals of the rheumatic diseases · 2022Trial
- Combined immunosuppressive treatment (CIST) in lupus nephritis: a multicenter, randomized controlled study.Clinical rheumatology · 2019Trial
- Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis.Annals of the rheumatic diseases · 2016Trial
- Allogeneic mesenchymal stem cell transplantation for lupus nephritis patients refractory to conventional therapy.Clinical rheumatology · 2014Trial
- [Mycophenolate mofetil seems to be superior to azothioprine in maintenance therapy of lupus nephritis].Zeitschrift fur Rheumatologie · 2012Trial
- Repeat Kidney Biopsy in Lupus Nephritis: Diagnostic Yield and Clinical Utility in a Real-World Single-Centre Cohort.Journal of clinical medicine · 2026Article
- Long-term B-cell depletion with rituximab in relapsing, refractory and severe lupus nephritis: a retrospective case series.Clinical kidney journal · 2026Article
- Article
- A Pooled Analysis of Sex Differences in Lupus Nephritis.Kidney international reports · 2026Article
98 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 11 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong-term immunosuppressive treatment does not efficiently prevent relapses of lupus nephritis (LN). This investigator-initiated randomised trial tested whether mycophenolate mofetil (MMF) was superior to azathioprine (AZA) as maintenance treatment.
methodsA total of 105 patients with lupus with proliferative LN were included. All received three daily intravenous pulses of 750 mg methylprednisolone, followed by oral glucocorticoids and six fortnightly cyclophosphamide intravenous pulses of 500 mg. Based on randomisation performed at baseline, AZA (target dose: 2 mg/kg/day) or MMF (target dose: 2 g/day) was given at week 12. Analyses were by intent to treat. Time to renal flare was the primary end point. Mean (SD) follow-up of the intent-to-treat population was 48 (14) months.
resultsThe baseline clinical, biological and pathological characteristics of patients allocated to AZA or MMF did not differ. Renal flares were observed in 13 (25%) AZA-treated and 10 (19%) MMF-treated patients. Time to renal flare, to severe systemic flare, to benign flare and to renal remission did not statistically differ. Over a 3-year period, 24 h proteinuria, serum creatinine, serum albumin, serum C3, haemoglobin and global disease activity scores improved similarly in both groups. Doubling of serum creatinine occurred in four AZA-treated and three MMF-treated patients. Adverse events did not differ between the groups except for haematological cytopenias, which were statistically more frequent in the AZA group (p=0.03) but led only one patient to drop out.
conclusionsFewer renal flares were observed in patients receiving MMF but the difference did not reach statistical significance.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.