Tacrolimus versus cyclophosphamide as treatment for diffuse proliferative or membranous lupus nephritis: a non-randomized prospective cohort study

Lupus
S WangJ Chen

Abstract

Treatment of lupus nephritis (LN) with cyclophosphamide (CYC) is effective but retains a certain severe adverse effect. Tacrolimus (TAC) may be a suitable treatment for LN. Forty patients with diffuse proliferative or membranous LN were recruited for this non-randomized open-label study - 67.5% (27/40) had nephrotic proteinuria (>3.5 g/day) and 50.0% (20/40) had low estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73m(2)). We compared the efficacy and adverse effects of TAC (0.04-0.08 mg/kg/d)/prednisone for 12 months (TAC group, n = 20) with intravenous CYC (750 mg/m(2) per month)/prednisone for six months followed by azathioprine (Aza) (100 mg/day)/prednisone for six months (CYC group, n = 20). The TAC target concentration was 6-8 ng/mL or 4-6 ng/mL, respectively, when induction or maintenance therapy was required and 4.0 ng/mL for patient with renal insufficiency. In the TAC group, mean urinary protein excretion decreased significantly from 5.00 ± 1.91 g/day at baseline to 2.54 ± 1.68 g/day after two weeks of therapy (P < 0.001), compared with the CYC group (4.9 ± 19.4 g/day), P = 0.001, and 65.0% (13/20) achieved partial remission at one month, compared with the CYC group (0/20), P < 0.001. The incidence of complet...Continue Reading

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Citations

Jan 3, 2014·International Journal of Rheumatic Diseases·Chi Chiu MokUNKNOWN Asian Lupus Nephritis Network (ALNN)
Jan 11, 2013·Arthritis Research & Therapy·Aisha Lateef, Michelle Petri
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Sep 26, 2020·Journal of Clinical Pharmacy and Therapeutics·Xiao ChenZhi-Ping Li
Jan 31, 2021·International Journal of Molecular Sciences·Carlos Rafael-VidalSamuel Garcia

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Methods Mentioned

BETA
enzyme-linked immunosorbent assay

Software Mentioned

SPSS

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