&lt;p&gt;Efficacy and safety of tacrolimus in induction therapy of patients with lupus nephritis&lt;/p&gt;

Zhou, Tian-Biao; Lin, Shujun; Shen, Yang; Lin, Wen‐Shan

doi:10.2147/dddt.s189156

Cited by 24 publications

(19 citation statements)

References 28 publications

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“…In fact, combination therapy with a steroid, TAc and MMF has achieved a good therapeutic effect in clinical practice in LN. Previous studies have found that the combination of TAc and MMF is more effective and safer than conventional treatment (intravenous cyclophosphamide and steroid) (9,10,21,22). Some studies have reported that TAc combined with MMF treatment may be a beneficial option for patients with LN who exhibit an inadequate response to either cyclophosphamide or MMF treatment, or had lupus flares after achieving a complete response (23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the inhibitory effect of tacrolimus combined with mycophenolate mofetil on mesangial cell proliferation based on the cell cycle

et al. 2020

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The inhibition of mesangial cell proliferation has become an important therapy for the prevention of glomerular proliferation-associated diseases. The combined application of immunosuppressants with multiple targets presents a novel direction in the treatment of kidney diseases. The present study was designed to explore the inhibitory effects of tacrolimus (TAc) combined with mycophenolate mofetil (MMF) on the proliferation of mesangial cells based on the cell cycle. In vitro, the levels of the proliferation index markers, Ki67 and cyclin d1, in human mesangial cells (HMcs) were determined by immunofluorescence staining and western blot analysis, respectively. In mice with lupus nephritis (LN), the proliferation of mesangial cells was determined using PAS and Masson's trichrome staining, while immunohistochemistry was used to detect Ki67 and western blot analysis was employed for the evaluation of cyclin d1 levels. The expression of platelet-derived growth factor (PdGF), a proliferation-associated protein, was estimated using immunohistochemistry and western blot analysis. In patients with LN, Ki67, cyclin d1 and PdGF expression was estimated by immunohistochemistry. The transforming growth factor-β1/Smad pathway influenced by TAC and the p38 pathway influenced by MMF were also examined by western blot analysis. The results suggested that the combination of TAc and MMF at half the concentration based on the cell cycle was more effective than monotherapy in inhibiting mesangial cell proliferation in vitro and in vivo. TAc inhibited HMc proliferation by affecting the Smad2 signaling pathway. MMF inhibited HMc proliferation by affecting the p38 signaling pathway. combined treatment with TAC and MMF significantly improved the clinical indexes of patients with LN without severe adverse effects. On the whole, the findings of the present study validate and reinforce the potential use of the combination of TAc and MMF for the treatment of mesangial proliferative diseases.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the inhibitory effect of tacrolimus combined with mycophenolate mofetil on mesangial cell proliferation based on the cell cycle

et al. 2020

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“…The Monte Carlo method was used for the simulation of the optimal initial dose, including six weight groups (10, 20, 30, 40, 50 and 60 kg) and seven initial dosing regimens (0.01, 0.05, 0.10, 0.15, 0.20, 0.25 and 0.30 mg/kg daily) split into two doses. Based on previous publications, the therapeutic window of tacrolimus treatment in LN is between 5 and 15 ng/ml; thus, this was used in the present study (10).…”

Section: Evaluation and Simulationmentioning

confidence: 99%

“…Lupus nephritis (LN) is one of the most severe complications of SLE and its incidence rate reaches up to 60% in patients with SLE worldwide. Among patients with SLE, 50-80% are cases of pediatric-onset SLE (7)(8)(9)(10). As comprehensively reviewed (10), without pharmacotherapy, long-term LN may induce irreversible renal injury and subsequently develops into end-stage renal disease.…”

Section: Introductionmentioning

confidence: 99%

“…Among patients with SLE, 50-80% are cases of pediatric-onset SLE (7)(8)(9)(10). As comprehensively reviewed (10), without pharmacotherapy, long-term LN may induce irreversible renal injury and subsequently develops into end-stage renal disease. Traditional treatments of LN involve a combination therapy of cyclophosphamide with glucocorticoids, which have been demonstrated to improve the long-term prog nosis.…”

Section: Introductionmentioning

confidence: 99%

“…Novel immunosuppressants, including tacrolimus, cyclosporine and mycophenolate mofetil are required to inhibit the side effects of traditional treatments. Tacrolimus has been reported to be a safe and effective agent for treating patients with LN (10).…”

Section: Introductionmentioning

confidence: 99%

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Population pharmacokinetics model and initial dose optimization of tacrolimus in children and adolescents with lupus nephritis based on real‑world data

Chen

Wang

et al. 2020

Exp Ther Med

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The present study aimed to establish a population pharmacokinetics model of tacrolimus and further optimize the initial dosing regimen of tacrolimus in pediatric and adolescent patients with lupus nephritis (LN). Pediatric and adolescent patients with LN were recruited between August 2014 and September 2019 at the Children's Hospital of Fudan University (Shanghai, China). Relevant information was used to set up a population pharmacokinetics model with a Nonlinear Mixed Effect Model and the initial dosage regimen was simulated with the Monte Carlo method. Body weight and co-administration of wuzhi capsule were indicated to influence tacrolimus clearance in pediatric and adolescent patients with LN, and at the same body weight, the rate of tacrolimus clearance in patients without vs. with co-administration of wuzhi capsule was 1:0.71. In addition, in patients who were not administered wuzhi capsule, an initial dosage regimen of 0.15 mg/kg/day was recommended for a body weight of 10-23 kg and 0.10 mg/kg/day for 23-60 kg; in patients who were administered wuzhi capsule, an initial dosage regimen of 0.10 mg/kg/day was recommended for a body weight of 10-23 kg and 0.05 mg/kg/day for 23-60 kg. To the best of our knowledge, the present study was the first to establish a population pharmacokinetics model of tacrolimus in order to determine the optimal initial dosage regimen of tacrolimus in pediatric and adolescent patients with LN.

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Efficacy and safety of tacrolimus versus mycophenolate mofetil as induction treatment and low-dose tacrolimus as treatment for lupus nephritis: a meta-analysis

Lee

Song

2023

Z Rheumatol

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<p>Efficacy and safety of tacrolimus in induction therapy of patients with lupus nephritis</p>

Cited by 24 publications

References 28 publications

Evaluation of the inhibitory effect of tacrolimus combined with mycophenolate mofetil on mesangial cell proliferation based on the cell cycle

Evaluation of the inhibitory effect of tacrolimus combined with mycophenolate mofetil on mesangial cell proliferation based on the cell cycle

Population pharmacokinetics model and initial dose optimization of tacrolimus in children and adolescents with lupus nephritis based on real‑world data

Efficacy and safety of tacrolimus versus mycophenolate mofetil as induction treatment and low-dose tacrolimus as treatment for lupus nephritis: a meta-analysis

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