{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:13:28Z","timestamp":1788909208306,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,19]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Uncertainties exist about the use of mycophenolate mofetil (MMF) in anti-neutrophil cytoplasmatic antibody (ANCA)-associated vasculitis (AAV), particularly for remission maintenance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Systematic review and meta-analysis of phase II and III trials assessing the use of MMF in AAV, granulomatosis with polyangiitis and microscopic polyangiitis (MPA). A comprehensive search of several databases (Medline, EMBASE, Cochrane, Web of Science, Scopus) from inception to 5 May 2020 has been conducted. Trial data were extracted to estimate odds ratios (ORs) and estimates (ES) for MMF efficacy (remission-induction and maintenance). Severe adverse effects (SAEs) were collected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 565 articles captured, 10 met the predefined criteria, 5 phase II and 5 III trials; 4 assessed remission-induction, 3 remission maintenance and 3 both. The pooled OR for remission-induction at 6 months was 1.06 (95% confidence interval 0.74, 1.52), with no significant difference by subgroup meta-analysis of trials stratified by different study-level features (i.e. kidney disease, MPA, myeloperoxidase-ANCA positivity, newly diagnosed disease) (P\u00a0&amp;gt;\u00a00.05). The overall ES for remission maintenance at the end of follow-up ranged between 51% and 91% (I2\u00a0=\u00a074.8%). Subgroup meta-analysis identified kidney involvement as a possible source of heterogeneity, yielding a significantly higher rate of sustained remission in trials enrolling only patients with kidney involvement (92%, 76\u2013100%) versus those enrolling patients with and without kidney involvement (56%, 45\u201366%). Results were similar in multiple sensitivity analyses. During follow-up, the frequency of SAEs in MMF-based treatment arms was 31.8%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In AAV, MMF use was significantly associated with higher sustained remission rates in trials enrolling only patients with kidney involvement. These findings might influence clinical practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfab357","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T20:08:58Z","timestamp":1639253338000},"page":"2190-2200","source":"Crossref","is-referenced-by-count":24,"title":["Induction and maintenance of remission with mycophenolate mofetil in ANCA-associated vasculitis: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"37","author":[{"given":"Alvise","family":"Berti","sequence":"first","affiliation":[{"name":"Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento , Rheumatology, Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouaz","family":"Alsawas","sequence":"additional","affiliation":[{"name":"Evidence-Based Practice Center, Mayo Clinic , Rochester, MN, USA"},{"name":"Department of Pathology, University of Iowa , 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Experimental and Clinical Sciences \u2018Mario Serio\u2019, University of Firenze, and Nephrology Unit, Meyer Children's Hospital , Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Tesar","sequence":"additional","affiliation":[{"name":"Department of Nephrology, First Faculty of Medicine, Charles University and General University Hospital in Prague , Prague, Czechia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duvuru","family":"Geetha","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2326-1820","authenticated-orcid":false,"given":"Jae I l","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Yonsei University College of Medicine , Seoul, Republic of 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