Comparison of treatment response and serious infection using tacrolimus, tacrolimus with mycophenolate mofetil, in comparison to cyclophosphamide as induction treatment for lupus nephritis
- Authors
- Song, Gwan Gyu; Lee, Young Ho
- Issue Date
- 10월-2020
- Publisher
- DUSTRI-VERLAG DR KARL FEISTLE
- Keywords
- tacrolimus; tacrolimus plus MMF; CYC; lupus nephritis; network meta-analysis
- Citation
- INTERNATIONAL JOURNAL OF CLINICAL PHARMACOLOGY AND THERAPEUTICS, v.58, no.10, pp.550 - 556
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF CLINICAL PHARMACOLOGY AND THERAPEUTICS
- Volume
- 58
- Number
- 10
- Start Page
- 550
- End Page
- 556
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/52533
- DOI
- 10.5414/CP203736
- ISSN
- 0946-1965
- Abstract
- Aims. This study evaluated the relative efficacy and safety of tacrolimus, tacrolimus+mycophenolate mofetil (MMF), and cyclophosphamide (CYC) for lupus nephritis. Materials and methods: Randomized controlled trials (RCTs) were included to investigate the effectiveness and safety of tacrolimus, tacrolimus+MMF, and CYC as a lupus induction therapy. We performed a Bayesian network meta-analysis of the random effects to incorporate direct and indirect data from RCTs. Results: Four RCTs met the inclusion criteria, giving a sample size of 543 patients. Tacrolimus+MMF had a significantly higher overall response rate (complete plus partial remission) than CYC (OR 4.22, 95% credible interval (Crl) 11.02 - 29.23) and was more efficacious than tacrolimus (OR 2.02, 95% Crl 0.24 - 28.51). Tacrolimus had higher overall response than CYC (OR 2.14, 95% Crl 0.38 - 12.33). Ranking the treatments based on the surface under the cumulative ranking curve (SUCRA) suggested that tacrolimus+MMF was the best treatment by the overall response (SUCRA = 0.876), followed by tacrolimus (SUCRA = 0.533) and CYC (SUCRA = 0.091). Tacrolimus was the least likely to cause serious infections (SUCRA = 0.758), followed by CYC (SUCRA = 0.398) and tacrolimus+MMF (SUCRA = 0.345). Conclusion: Tacralimus+MMF was the most effective induction treatment for patients with lupus nephritis, and tacrolimus was the least likely to cause severe infections.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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