Efficacy and safety of tacrolimus monotherapy versus cyclophosphamide-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis.

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Date: July 16, 2021
From: Medicine(Vol. 100, Issue 28)
Publisher: Lippincott Williams & Wilkins, WK Health
Document Type: Article
Length: 622 words

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Byline: Lifeng Gong, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Min Xu, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Wei Xu, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Weigang Tang, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Jingkui Lu, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Wei Jiang, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Fengyan Xie, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Liping Ding, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. ; Xiaoli Qian, Department of Nephrology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China , Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University Changzhou, Jiangsu, China. Abstract OBJECTIVE: The objective of this meta-analysis was to compare the efficacy and safety of tacrolimus (TAC) monotherapy versus cyclophosphamide (CTX)-corticosteroid combination therapy in idiopathic membranous nephropathy (IMN) patients. METHODS: Databases including the PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched from inception to October 20, 2020. Eligible studies comparing TAC monotherapy and CTX-corticosteroid combination therapy in IMN patients were included. Data were analyzed using Review Manager Version 5.3. RESULTS: Nine studies were included in the meta-analysis. One randomized controlled trial and eight cohort studies involving 442 patients were identified. Compared with CTX-corticosteroid combination therapy for IMN, TAC monotherapy had higher complete remission (CR) at month 6 (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.35-3.50, P Çè Çè.05). There was no significant difference between the TAC group and the CTX combined with corticosteroid 0.5Çèmg/kg/day group concerning abnormal aminotransferase ( P Çè Çè.05). CONCLUSION: TAC monotherapy is comparable to CTX-corticosteroid combination therapy for renal remission in IMN patients. TAC monotherapy had a higher CR in the early stage and had fewer drug-related adverse effects. The relapse rate of TAC monotherapy was higher than that of CTX-corticosteroid combination therapy, but the difference was not significant.

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Gale Document Number: GALE|A732090897