Efficacy and Safety of Ciclosporin Combined with Glucocorticoid versus Cyclophosphamide Combined with Glucocorticoid in the Treatment of Membranous Nephropathy ：a Meta-analysis
- VernacularTitle:环孢素联合糖皮质激素对比环磷酰胺联合糖皮质激素治疗膜性肾病有效性与安全性的Meta分析
- Author:
Xiaohua LU
1
,
2
,
3
;
Yali ZHENG
1
,
2
,
3
;
Yongcai GAO
1
,
2
,
3
;
Li BAO
1
,
2
,
3
;
Hui WANG
1
,
2
,
3
;
Li CAO
1
,
2
,
3
;
Dacheng TIAN
1
,
2
Author Information
1. Ningxia Hui Autonomous Region People’s Hospital，Yinchuan 750002，China
2. The First Affiliated Hospital of Northwest University for Nationalities，Yinchuan 750002，China
3. The Affiliated Autonomous Region People’s Hospital of Ningxia Medical Univ ersity，Yinchuan 750002，China
- Publication Type:Journal Article
- Keywords:
Cyclosporin;
Cyclophosphamide;
Corticosteroid;
Membranous nephropathy;
Efficacy;
Safety;
Meta-analysis
- From:
China Pharmacy
2019;30(10):1407-1411
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE： To systematically evaluate the efficacy and safety of cyclosporin combined with glucocorticoid versus cyclophosphamide combined with glucocorticoid in the treatment of membranous nephropathy （MN）. METHODS： Retrieved from Embase， Medline， CNKI， VIP and Wanfang database， RCTs about cyclosporin combined with glucocorticoid （trial group） versus cyclophosphamide combined with glucocorticoid （control group） in the treatment of MN were collected. Meta-analysis was conducted by using Rev Man 5.3 statistical software after literature screening， data extraction and quality evaluation with Jadad scale. RESULTS： Totally 6 RCTs were included， involving 312 patients in total. Results of Meta-analysis showed that remission rate 3 months after treatment [OR＝3.42，95％CI（2.05，5.71），P＜0.000 01] and relapse rate [OR＝3.12，95％CI（1.45，6.70），P＝0.004]， leukocyte count 12 months after treatment [MD＝1.77，95％CI（0.96，2.58），P＜0.000 1] in trial group were significantly higher than control group. There was no statistical significance in remission rate 6 months after treatment [OR＝2.06，95％CI（0.80，5.30），P＝0.13] and remission rate 12 months after treatment [OR＝1.30，95％CI（0.68，2.48），P＝0.42]， blood creatinine level 3 months after treatment [MD＝－1.55，95％CI（－6.72，3.62），P＝0.56] and blood creatinine level 6 months after treatment [MD＝－1.21，95％CI（－5.96，3.54），P＝0.62]， cholesterol level 12 months after treatment [MD＝－0.77， 95％CI（－1.81，0.28），P＝0.15] or ALT level[MD＝－0.40，95％CI（－4.38，3.58），P＝0.98] between 2 groups. ADR were reported in 5 RCTs， but their results were different. CONCLUSIONS： Long-term efficacy of cyclosporine combined with corticosteroid is similar to that of cyclophosphamide combined with corticosteroid in the treatment of MN. Cyclosporin combined with glucocorticoid has a faster effect， but a higher relapse rate.
