Meta-analysis of tacrolimus and cyclophosphamide in the treatment of lupus nephritis
10.3760/cma.j.issn.1001-7097.2013.04.002
- VernacularTitle:他克莫司和环磷酰胺治疗狼疮肾炎的Meta分析
- Author:
Bin WANG
;
Min YANG
;
Min LI
;
Hua LIU
;
Yun ZOU
;
Jiarong PAN
- Publication Type:Journal Article
- Keywords:
Tacrolimus;
Lupus nephritis;
Cyclophosphamide;
Randomized controlled trials;
Cohort study;
Meta-analysis
- From:
Chinese Journal of Nephrology
2013;(4):248-252
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of tacrolimus and cyclophosphamide (CTX) on lupus nephritis.Methods The clinical trials on treatment of lupus nephritis with tacrolimus and CTX published before October 2012 were searched at Cochrane library,PubMed,OVID,Wanfang database,Chinese Journal full-text Database,Chongqing Weipu Database by using the methods of Cochrane systematic review.At the same time the information from related journals,professional data and network were hand-searched.The homogeneous evaluation was performed by Meta-analysis.Statistical analysis of clinical data was performed by using Stata11 software.Results A total of 4783 reports were found,while only 9 papers (8 randomized controlled trials and 1 cohort study) met the inclusion criteria.Tacrolimus group got better complete remission ratio (Z =4.05,P ＜ 0.01),similar partial remission ratio (Z =0.44,P =0.661),and better overall remission ratio (Z =4.29,P ＜ 0.01) as compared with CTX group.There were no significant differences between tacrolimus group and CTX group in the incidence of infection (Z=1.75,P=0.081),renal damage (Z=0.88,P=0.38) and abnormal glucose metabolism (Z =1.91,P =0.070).Side effects such as liver function impairment (Z =2.65,P＜0.01),gastrointestinal discomfort (Z=2.31,P＜0.05),menstrual disorders (Z=3.88,P＜0.01),bone marrow suppression (Z =3.29,P ＜ 0.01) in tacrolimus group were lower than those in CTX group.Conclusions Compared with CTX,tacrolimus has better complete remission ratio and overall remission ratio,with less side-effects in the treatment of lupus nephritis.However,large scale,multicenter,well-designed clinical trials should be adopted to further confirm the conclusions.
