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Mycophenolate mofetil: a step forward in the induction treatment of ANCA-associated vasculitis? Comment on the article by Jones et al

We have read with interest the results of the MYCYC trial showing that mycophenolate mofetil (MMF) is not inferior to intravenous cyclophosphamide (CYC) in achieving a primary remission in the treatment of ANCA-associated vasculitides (AAV).1 We would like to address several comments.

First, in a previous report of the MYCYC trial in 2013, the authors could not establish a non-inferiority of MMF compared with CYC because the lower bound of the 90% CI of the absolute risk difference (RD) crossed the prespecified non-inferiority margin of −12% (MMF: n=46/70 (66%) vs CYC: n=48/70 (69%), RD=−3%, 90% CI −16% to 10%, p=0.06).2 In the current publication, the reported primary remission rates at 6 months are slightly different compared …