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. 2024 Dec 18;8(1):68.
doi: 10.1186/s41927-024-00439-x.

Effect of tacrolimus with mycophenolate mofetil or cyclophosphamide on the renal response in systemic lupus erythematosus patients

Siqin Sun #  1 , Xueyi Zhang #  1 , Qingqing Guo #  1 , Xiaojun Tang  2 , Wei Shen  2 , Jun Liang  2 , Genhong Yao  2 , Linyu Geng  2 , Shuai Ding  2 , Hongwei Chen  2 , Hong Wang  2 , Bingzhu Hua  2 , Huayong Zhang  2 , Xuebing Feng  2 , Ziyi Jin #  3   4 , Lingyun Sun #  5   6   7   8
Affiliations

Effect of tacrolimus with mycophenolate mofetil or cyclophosphamide on the renal response in systemic lupus erythematosus patients

Siqin Sun et al. BMC Rheumatol. .

Abstract

Objective: This study aimed to determine the therapeutic efficacy of tacrolimus (TAC) with mycophenolate mofetil (MMF) or cyclophosphamide (CYC) on the renal response in systemic lupus erythematosus (SLE) patients.

Methods: A retrospective cohort study based on medical data was conducted among SLE patients who took at least one of the following medicines in 2010-2021: TAC, MMF and CYC. The odds ratio (OR) and 95% confidence interval (CI) were calculated, and the synergistic interaction was estimated using logistic regression models.

Results: Among 793 SLE patients, 27.9% patients (221 cases) achieved CR after at least 3 months. The TAC use was positively associated with CR with an adjusted OR (95% CI) of 2.82 (1.89, 4.22) overall and in subgroups of SLE patients with SLEDAI scores > 12, moderate or severe urinary protein and comorbidities. The dose-response effect on CR was also observed at TAC doses greater than 4 mg/d and more than 180 days, with adjusted ORs (95% CIs) of 5.65 (2.35, 13.55) and 3.60 (2.02, 6.41), respectively. Moreover, the combined effect of TAC with MMF or CYC was better than that of monotherapy, there was significant synergistic interactions with adjusted ORs (95% CIs) of 2.43 (1.20, 4.92) and 3.14 (1.49, 6.64), respectively, and similar results were observed for the combination of different doses of TAC with MMF or CYC.

Conclusion: TAC can effectively alleviate the condition of patients with SLE and may interact with MMF or CYC, which suggests that the combination therapy of TAC with MMF or CYC may produce greater benefits for patients with SLE.

Trial registration: This is a purely observational study that does not require registration.

Keywords: Cyclophosphamide; Dose-response; Lupus nephritis; Mycophenolate mofetil; Tacrolimus.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of Nanjing Drum Tower Hospital. (Project code 2022-220-02). Written informed consent was exempt from the ethics approval requirements according to national legislation from the National Health and Family Planning Commission of China. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

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Fig. 1
Selection of patients for the study
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References

    1. Wardowska A. The epigenetic face of lupus: focus on antigen-presenting cells. Int Immunopharmacol. 2020. 10.1016/j.intimp.2020.106262. - PubMed
    1. Yap DY, Chan TM. Lupus Nephritis in Asia: clinical features and management. Kidney Dis (Basel). 2015;1(2):100–9. 10.1159/000430458. - PMC - PubMed
    1. Mahajan A, Amelio J, Gairy K, Kaur G, Levy RA, Roth D, et al. Systemic lupus erythematosus, lupus nephritis and end-stage renal disease: a pragmatic review mapping disease severity and progression. Lupus. 2020;29(9):1011–20. 10.1177/0961203320932219. - PMC - PubMed
    1. Li M, Zhao Y, Zhang Z, Huang C, Liu Y, Gu J, et al. 2020 Chinese guidelines for the diagnosis and treatment of systemic Lupus Erythematosus. Rheumatol Immunol Res. 2020;1(1):5–23. 10.2478/rir-2020-0009. - PMC - PubMed
    1. Fanouriakis A, Bertsias G. Changing paradigms in the treatment of systemic lupus erythematosus. Lupus Sci Med. 2019;6(1):e000310. 10.1136/lupus-2018-000310. - PMC - PubMed

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