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CHES Rounds
Start date:
Monday, January 11, 2016
Noon – 1:00p.m.
PGCRL CHES Conference Room 11.9701

Effectiveness of mycophenolate mofetil in the treatment of childhood-onset proliferative lupus nephritis:
Using a marginal structural model

Objective: There is no rigorous trial evidence to support the treatment effectiveness of any therapy for children with proliferative lupus nephritis (PLN). Marginal structural models (MSMs) enable us to estimate treatment effectiveness using observational data while accounting for confounding by indication.

Methods: We used our childhood-onset PLN cohort. The outcome was the estimated glomerular filtration rate (eGFR) using the revised Schwartz formula, and those who used mycophenolate mofetil (MMF) were compared to those who used other therapies over time. Confounding by indication was corrected for using an MSM model.

Results: A total of 172 subjects less than 18 years of age were included, with a mean follow-up duration of approximately 4 years. The relative effect estimate for MMF versus other therapies was 1.05, i.e., 5% better eGFR on average (95% confidence interval: 0.5%, 10%), corrected for potential confounding by indication.

Conclusion: MMF appears to be somewhat more beneficial than other competing therapies in improving renal function, in the short to medium term, for childhood-onset PLN. This finding is consistent with trial evidence for adult PLN.

Presented by:

Simon Tian MSc, PhD(c)

Simon Tian has a medical background from China. He obtained a M.Sc. degree in neuroscience from the University of Toronto in 2006 and is currently completing his Ph.D. in clinical epidemiology and biostatistical methodology at The Hospital for Sick Children and University of Toronto. Simon Tian also spends time working as a teaching assistant for several biostatistics courses for students in the M.Sc./Ph.D. program at the University of Toronto, and working as a biostatistician (II) for the contract research organization Everest Clinical Research. During this presentation, Simon will be talking about one of his doctoral research project, which is currently under internal review and will soon be submitted for publication.

Hosted by:

Dr. Martin Offringa  –  Head & Sr. Scientist – CHES  

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