Effect and safety evaluation of tacrolimus and tripterygium glycosides combined therapy in treatment of Henoch–Schönlein purpura nephritis

Abstract

Henoch-Sch€ onlein purpura nephritis has become a significant threat to children's health. Traditional combined therapy of glucocorticoids and cyclophosphamide leads to severe toxicity and complications. Therefore, identifying a feasible and effective strategy with low side-effects for the treatment of Henoch-Sch€ onlein purpura nephritis is of great significance. Methods: A randomized, controlled trial was carried out. A total of 279 children with Henoch-Sch€ onlein purpura nephritis were recruited and randomly divided into three groups: control group (receiving the current standard therapy), TA group (receiving tacrolimus) and TA + tripterygium glycosides group (receiving tacrolimus + tripterygium treatment). The total duration of the trial was 6 months, and the duration of follow-up observation was 9 months. Results: Various therapies showed similar therapeutic effects in the third and sixth months. The relief of Henoch-Sch€ onlein purpura nephritis symptoms caused by TA + tripterygium glycosides was slower than the TA and control groups. The incidence of adverse reactions in the TA + tripterygium glycosides group was lower in the control and TA groups. The final treatment effect of the experimental groups was better than the control group. The recurrence rate in the TA + tripterygium glycosides group was also significantly lower. Conclusion: Tacrolimus and tripterygium glycosides combined therapy had better effects and safety for long-term treatment of Henoch-Sch€ onlein purpura nephritis.

Effectiveness and safety of tripterygium wilfordii poly-glycosides on glomerulonephritis: a systematic review and meta-analysis

“…Consequently, one article was excluded due to the unavailability of the necessary data, while the other two were retained because they provided data for some of the required indicators. Ultimately, 13 articles were included in this meta-analysis ( Deng et al, 2010 ; Deng et al, 2012 ; Ge et al, 2013 ; Wu et al, 2013 ; Liu et al, 2015 ; Shang et al, 2018 ; Wang, 2018 ; Xiong et al, 2020 ; Gao et al, 2021 ; Guo et al, 2021 ; Jin et al, 2021 ; Zhang et al, 2021 ; Wang et al, 2022 ). Of these articles, ten featured two parallel groups, while the remaining three included three parallel groups.…”

“…Three retrospective cohorts, one prospective controlled open-label study, and one RCT investigated the effectiveness of adding TWP to conventional treatment in pediatric HSPN ( Deng et al, 2010 ; Deng et al, 2012 ; Wu et al, 2013 ; Jin et al, 2021 ; Zhang et al, 2021 ). Clinical remission was reported in four of these five studies ( Deng et al, 2010 ; Deng et al, 2012 ; Wu et al, 2013 ; Jin et al, 2021 ).…”

Network Pharmacology and Experimental Validation to Explore That Celastrol Targeting PTEN is the Potential Mechanism of Tripterygium wilfordii (Lév.) Hutch Against IgA Nephropathy

“…In the research of treatment of kidney disease, Tripterygium relates drugs have been proven to be effective in reducing proteinuria, improving renal function, and lowering the recurrence rate, in the meanwhile, the incidence of adverse reactions. 13 , 28 , 29 In the study of mechanism, the pharmacological effect of Tripterygium component is mainly reflected in anti-inflammatory and immune regulation, including regulating MAPK 30 and TLR4/NF-κB 31 classic inflammation signal pathway, declining the NLRP3 inflammasome, 32 and improving the Oxidative Stress. 33 MAPK/ERK pathway has been proved to play a significant role in the injury of IgAN mesangial cells.…”

Recurrence of Henoch Schoenlein Purpura Nephritis in Children: A Retrospective Study

“…A more recent randomized controlled trial by Zhang H et al on 279 children with HSPN showed the effectiveness and safety of tacrolimus regiment for long-term treatment of HSPN. Also, tacrolimus was shown to significantly lower the HSPN recurrence rate [ 18 ]. In our study, patients were administered tacrolimus in combination with either prednisone acetate or mycophenolate mofetil or both.…”