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. 2019 Mar 12:13:857-869.
doi: 10.2147/DDDT.S189156. eCollection 2019.

Efficacy and safety of tacrolimus in induction therapy of patients with lupus nephritis

Tianbiao Zhou  1 , Shujun Lin  1 , Shen Yang  2 , Wenshan Lin  1
Affiliations

Efficacy and safety of tacrolimus in induction therapy of patients with lupus nephritis

Tianbiao Zhou et al. Drug Des Devel Ther. .

Abstract

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: CR; TR; complete remission; lupus nephritis; meta-analysis; tacrolimus; total remission.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Assessment of the efficacy of tacrolimus in patients with lupus nephritis (TAC + GC vs CYC + GC). Abbreviations: TAC, tacrolimus; GC, glucocorticoids; CYC, cyclophosphamide; CR, complete remission; TR, total remission (complete plus partial remission); SLE-DAI, systemic lupus erythematosus disease activity index; M–H, Mantel–Haenszel.
Figure 2
Figure 2
Assessment of the efficacy of tacrolimus in patients with lupus nephritis (TAC + GC vs MMF + GC). Abbreviations: TAC, tacrolimus; GC, glucocorticoids; MMF, mycophenolate mofetil; CR, complete remission; TR, total remission, complete plus partial remission; M–H, Mantel–Haenszel.
Figure 3
Figure 3
Assessment of the efficacy of tacrolimus in patients with lupus nephritis (TAC + MMF + GC vs CYC + GC). Abbreviations: TAC, tacrolimus; MMF, mycophenolate mofetil; GC, glucocorticoids; CYC, cyclophosphamide; CR, complete remission; TR, total remission, complete plus partial remission; M–H, Mantel–Haenszel.
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