Tacrolimus Combined With Corticosteroids in Treatment of Nephrotic Idiopathic Membranous Nephropathy: A Multicenter Randomized Controlled Trial

Chen, Min; Wang, Haiyan; Li, Hang; Li, Xuewang; Li, Xia-Yu; Chen, Jianghua; Lu, Fuming; Ni, Zhaohui; Xu, Fei

doi:10.1097/maj.0b013e3181ca3a7d

Cited by 107 publications

(108 citation statements)

References 26 publications

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“…Since then, several RCTs have been published [54][55][56][57] that confirm the previously reported high remission rates. However, these trials lack sufficient follow-up to evaluate relapse rate or draw conclusions regarding hard renal end points.…”

Section: Treatmentsupporting

confidence: 66%

See 1 more Smart Citation

Pharmacological treatment of primary membranous nephropathy in 2016

Logt¹,

Hofstra²,

Wetzels³

2016

Expert Review of Clinical Pharmacology

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Section: Treatmentsupporting

confidence: 66%

“…In the study by Chen et al, patients were followed for only 12 months after start of therapy, and only 3 months after withdrawal of tacrolimus [54]. This explains the rather low 18% relapse rate.…”

Section: Treatmentmentioning

confidence: 99%

Pharmacological treatment of primary membranous nephropathy in 2016

Logt¹,

Hofstra²,

Wetzels³

2016

Expert Review of Clinical Pharmacology

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“…Chen et al failed to show superiority for tacrolimus over cyclophosphamide in complete or partial remission (CR + PR) at the end of follow-up (14). Dussol et al also failed to demonstrate an effect of mycophenolate mofetil on CR + PR (15).…”

Section: Introductionmentioning

confidence: 97%

“…Tacrolimus significantly reduced proteinuria at the end of follow-up (range, 9-30 months) in three studies (n=145 patients) (MD, -1.06 g/24 h [-1.66 to -0.47]; P,0.001) (10,14,47).…”

Section: Tacrolimus 6 Corticosteroids Versus No Treatment or Corticosmentioning

confidence: 99%

Immunosuppression for Membranous Nephropathy

Chen

Schieppati

Cai

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The efficacy and safety of immunosuppression for idiopathic membranous nephropathy (IMN) with nephrotic syndrome are still controversial. A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed. Conclusions Alkylating agents plus corticosteroids had long-term and short-term benefits for adult IMN, but resulted in more withdrawals or hospitalizations.

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“…Praga et al (10) reported approvingly the efficacy of tacrolimus monotherapy in IMN patients with NS and Ballarin et al (11) used a combination of tacrolimus, prednisone and mycophenolate mofetil in IMN therapy and demonstrated a 73.4% the remission rate. In addition, a clinical trial in China reported an 85% remission rate with tacrolimus versus 65% with cyclophosphamide in IMN patient therapy (12). A total of 259 patients in four studies showed that therapy with tacrolimus plus corticosteroid had a higher complete remission rate compared to therapy with cyclophosplamide plus corticosteroid (P < 0.05), however it was not significant on total remission, partial remission and adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy of Tacrolimus Versus Cyclosporine in the Treatment of Idiopathic Membranous Nephropathy

et al. 2016

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Background: Immunosuppressive drugs have received the most attention for Idiopathic Membranous Nephropathy (IMN) that include alkylating agents such as tacrolimus and cyclosporine. Objectives: This study was aimed to evaluate the efficacy of tacrolimus versus cyclosporine in the treatment of IMN in the Western region of Iran. Methods: This clinical trial and double-blind study was performed on IMN patients based on the primary biopsy with a range of 15 to 70 years. The patients with secondary membranous nephropathy such as hepatitis B, hepatitis C and systemic lupus erythematosus were censored from the study. Group C was treated with cyclosporine 3 -6 mg/kg/d and a low dose of prednisolone and Group T was treated with tacrolimus 0.05 mg/kg/d and low dose of prednisolone. Results: 68 patients were entered in our study, 34 patients were randomly selected in Group T and 34 patients in Group C. The 24-hour urine protein reduced significantly in the two groups after the 3rd and the 6th month compared with the baseline. Uric acid increased in Group T after 3 and 6 months compared with the baseline (P < 0.05), but there was no significant difference in Group C. Creatinine clearance increased in two groups after 3 and 6 months compared with the baseline, however, it has been just as significant in Group T after 6 months. There was no significant difference in the two groups after 3 or 6 months from the first dialysis. Conclusions: Cyclosporine and tacrolimus reduce proteinuria and serum creatinine after 6 months. Nonetheless, tacrolimus reduces urea and cyclosporine increases it. However, since the prevalence of the side effects of both drugs is similar, tacrolimus has better results in the treatment of IMN patients compared with cyclosporine.

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Tacrolimus Combined With Corticosteroids in Treatment of Nephrotic Idiopathic Membranous Nephropathy: A Multicenter Randomized Controlled Trial

Cited by 107 publications

References 26 publications

Pharmacological treatment of primary membranous nephropathy in 2016

Pharmacological treatment of primary membranous nephropathy in 2016

Immunosuppression for Membranous Nephropathy

Comparison of the Efficacy of Tacrolimus Versus Cyclosporine in the Treatment of Idiopathic Membranous Nephropathy

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