Efficacy and safety of tacrolimus in induction therapy of patients with lupus nephritis
Authors Zhou TB, Lin SJ, Yang S, Lin WS
Received 29 September 2018
Accepted for publication 5 February 2019
Published 12 March 2019 Volume 2019:13 Pages 857—869
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 2
Editor who approved publication: Dr Sukesh Voruganti
Tianbiao Zhou,1 Shujun Lin,1 Shen Yang,2 Wenshan Lin1
1Department of Nephrology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China; 2Department of Nephrology, Huadu District People’s Hospital of Guangzhou, Southern Medical University, Guangzhou 510800, China
Background: The purpose of this study was to detect the efficacy and safety of tacrolimus (TAC) in induction therapy of patients with lupus nephritis.
Methods: Associated studies were extracted from the PubMed and the Cochrane Library on July 10, 2018, and applicable investigations were pooled and analyzed by meta-analysis. Data on complete remission (CR), total remission (TR; complete plus partial remission), proteinuria levels, urine erythrocyte number, albumin, glomerular filtration rate, negative rate of ds-DNA, C3 levels, C4 levels, systemic lupus erythematosus disease activity index (SLE-DAI), etc, were extracted and pooled using RevMan 5.3.
Results: In the therapeutic regimen of TAC + glucocorticoids (GC) vs cyclophosphamide (CYC) + GC, the results indicated that the TAC group had high values of CR, TR, albumin, and negative rate of ds-DNA, and low values of proteinuria levels and SLE-DAI when compared with those in CYC group (all P<0.05). In the therapeutic regimen comprising TAC + GC vs mycophenolate mofetil (MMF) + GC, the results indicated that the difference of CR, TR, proteinuria levels, and albumin between TAC group and MMF group were not significant (all P>0.05). In the therapeutic regimen comprising TAC + MMF + GC vs CYC + GC, multitarget therapy group showed higher values of CR, TR, urinary protein decline, and rise of serum albumin when compared with CYC group (all P<0.05).
Conclusion: TAC is an effective and safe agent in induction therapy of patients with lupus nephritis.
Keywords: tacrolimus, lupus nephritis, complete remission, CR, total remission, TR, meta-analysis
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