Maintenance therapy for lupus nephritis with mycophenolate mofetil or azathioprine. A meta-analysis

Deng, Jin; Xie, Huan; Zhu, Lin; Luo, Lei; Xie, Hua

doi:10.5414/cn109450

Cited by 15 publications

(14 citation statements)

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“…Thus, renal impairment and glucocorticoid treatment are involved in dyslipidemia in the patients with SLE. Additionally, diabetes mellitus, cardiovascular disease, liver and thyroid disease could also lead to changes in lipid profile [29][30][31]; menopaused or pregnant subjects showed increased TC and LDL-C [32]; abnormal BMI, smoking, alcohol use or taking any drugs known to influence lipid metabolism or the endocrine system could affect the results [33][34][35]. Therefore, based on these restricted inclusion criteria, our present analysis was able to assess the effects of the disease itself on lipid metabolism.…”

Section: Discussionmentioning

confidence: 99%

Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study

2020

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Background: Recent studies showed that dyslipidemia could be a critical factor in the progression of cardiovascular disease in systemic lupus erythematosus (SLE). The aim of the present study was to describe the relationship between serum lipid profile and SLE disease activity in young female adults with SLE. Methods: Seventy-one female subjects diagnosed with SLE aged 20~30 years were enrolled. Serum lipid profile including TC, TG, HDL-C, LDL-C, VLDL-C, Apo A, Apo B, and Apo E were evaluated between control and young female SLE patients. Univariate correlation analyses were performed to explore the correlation between serum lipid levels and SLE disease activity. Results: Our results showed that TG and VLDL-C levels were significantly increased in young female SLE as compared to control, with TC, HDL-C, LDL-C, Apo A, and Apo B significantly reduced. Meanwhile, univariate correlation analyses showed negative correlations between SLE disease activity index and HDL-C, LDL-C, Apo A, and Apo B; with positive correlations between SLE disease activity index and TG and VLDL-C. Conclusion: Serum lipid profile was significantly dysregulated in young female SLE patients. Moreover, SLE disease activity was correlated to the serum lipid levels, supporting the notion that the young patients with SLE might also have a higher risk of cardiovascular disease.

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Section: Discussionmentioning

confidence: 99%

Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study

2020

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“…No differences were found between CNI or CPA vs. AZA (Table 14) [13]. MMF was associated with reduced relapse rate as compared to AZA in network meta-analysis only, and this effect was concordant with the study with the largest effect size (Table 14) [16,18]. Heterogeneity was low in MMF vs. AZA and CNI vs. AZA comparisons.…”

Section: Relapse During Maintenance Therapy In Lupus Nephritismentioning

confidence: 77%

Induction and Maintenance Treatment of Lupus Nephritis: A Comprehensive Review of Meta-Analyses

Smıth

Park

et al. 2022

JCM

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Background: Lupus nephritis (LN) is present in over 50% of patients with systemic lupus erythematosus (SLE) which is managed with immunosuppressive and immunomodulatory therapies. However, several novel therapeutic approaches for LN are under investigation due to the adverse effects spectrum of conventional therapy; Methods: We performed a comprehensive review of meta-analyses aggregating the comparative efficacies of various pharmacotherapies for LN. We conducted a literature search and retrieved a total of 23 meta-analyses and network meta-analyses for summarization. Pharmacotherapies were evaluated across six major outcomes: remission, relapse, mortality, end stage kidney disease (ESKD) progression, infection, and malignancy. Result: Calcineurin inhibitors (CNI), particularly tacrolimus (TAC), in combination with glucocorticoids (GC) outperformed cyclophosphamide (CPA) with GC in the rate of remission, either complete or partial remission, and in terms of infectious complications. In maintenance therapy, MMF was superior to azathioprine (AZA) as the MMF-treated patients had lower relapse rate. Interpretation: This review aggregates evidence of therapy for clinicians and sheds light on comparative efficacies of alternative LN treatments. As more promising agents are entering the market, such as voclosporin, belimumab, and obinutuzumab, LN management might undergo significant changes during the next years.

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“…[102][103][104] For patients with Type II lupus nephritis who are at risk of histological transformation, [105,106] [75] However, another meta-analysis showed that there were no statistically significant differences in mortality, incidence of end-stage renal disease, nor disease relapse between mycophenolate mofetil and azathioprine during the maintenance treatment period. [107] One network meta-analysis showed that glucocorticoids in combination with mycophenolate mofetil and calcineurin inhibitors were more effective than glucocorticoids monotherapy in inducing remission of Type V lupus nephritis (most with renal proteinuria). The effect of azathioprine combined with glucocorticoids was not significantly different from glucocorticoids monotherapy.…”

Section: Rituximab Nomentioning

confidence: 99%

2020 Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus

Zhao

Zhang

et al. 2020

Rheumatology and Immunology Research

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Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease that represents a prodigious challenge of diagnosis and treatment. In 2019, under the leadership of the Chinese Rheumatology Association, a multidisciplinary guideline development group was established to develop an evidence-based diagnosis and treatment guideline for patients with SLE in PR China. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence and the strength of recommendations. The guideline was reported following the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist. In this guideline, we provided recommendations for SLE classification criteria, disease activity monitoring and assessment, medication administration and considerations for SLE patients with organs and systems involved, and management of special populations such as SLE patients in the setting of pregnancy. This guideline serves as an evidence-based tool for Chinese clinicians to diagnose and treat patients with SLE.

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Maintenance therapy for lupus nephritis with mycophenolate mofetil or azathioprine. A meta-analysis

Cited by 15 publications

References 0 publications

Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study

Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study

Induction and Maintenance Treatment of Lupus Nephritis: A Comprehensive Review of Meta-Analyses

2020 Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus

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