Hepatitis, Autoimmune ; classification ; diagnosis ; therapy ; Humans ; Immunosuppressive Agents ; therapeutic use

BACKGROUNDThe efficacy and safety of immunosuppression for idiopathic membranous nephropathy (IMN) are still controversial. Recent studies showed tacrolimus is effective in the treatment of IMN. To evaluate the efficacy and safety of tacrolimus (TAC) for IMN, we conducted a meta-analysis of published medical literatures.

METHODSStudies addressing the effect of tacrolimus in IMN were searched on PUBMED, EMBASE, The Cochrane Library, and ClinicalTrials.gov (March 2013). Trials comparing tacrolimus with corticosteroid versus control group (cyclophosphamide with corticosteroid) were included. The quality of the studies was assessed using Jadad method. Statistical analyses were performed using Review Manager 5.2 and the results were summarized by calculating the risk ratio (RR) for dichotomous data or the mean difference (MD) for continuous data with 95% confident interval (CI).

RESULTSA total of four studies (259 patients) were included. It was shown that therapy with tacrolimus plus corticosteroid had a higher complete remission rate compared to therapy with cyclophosplamide plus corticosteroid (RR = 1.53, 95% CI: 1.05-2.24, P < 0.05), but not significant on total remission, partial remission and adverse effects. Also, no significant alterations were observed in proteinuria and serum albumin level between the two groups. During the entire follow-up period, serum creatinine level remained stable in both groups without = 50% increase in its level.

CONCLUSIONSTAC is more effective than cyclophosphamide (CTX) by achieving complete remission in patients with IMN. Multi-ethnic RCTs are needed to evaluate its long-term efficacy and safety.

Adrenal Cortex Hormones ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Glomerulonephritis, Membranous ; drug therapy ; Humans ; Immunosuppressive Agents ; therapeutic use ; Tacrolimus ; therapeutic use

Anemia, Aplastic/drug therapy* ; Benzoates/therapeutic use* ; Cyclosporine/therapeutic use* ; Humans ; Hydrazines/therapeutic use* ; Immunosuppressive Agents ; Pyrazoles/therapeutic use*

No abstract available.
Azathioprine/*therapeutic use ; Crohn Disease/*drug therapy ; Female ; Humans ; Immunosuppressive Agents/*therapeutic use ; Leukocytes/*cytology ; Male

Fibrosis ; drug therapy ; metabolism ; Humans ; Immunosuppressive Agents ; therapeutic use ; Models, Biological ; Sirolimus ; therapeutic use

Treatment of myelodysplastic syndrome (MDS) remains unsatisfactory. It is possible that immunosuppressive therapy might be effective for a certain subset of patients with MDS. In this review 105 patients with MDS who were treated with cyclosporin A (CsA) including 90 RA, 5 RARS, 10 RAEB, were analyzed. The dose of CsA was 2 - 12 mg/(kg x d) for at least three months. Hematological improvement was observed in 64 patients (61%), and complete remission was observed in 14 patients (13.3%). These results indicated that CsA immunosuppressive therapy may be useful for IPSS low, intermediate-1 and intermediate-2 MDS patients.
Cyclosporine ; adverse effects ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Myelodysplastic Syndromes ; drug therapy ; immunology

The purpose of this study was to evaluate the efficacy of immunosuppressive agents, 99Tc-MDP and both of them in treating patients with Graves' ophthalmopathy(GO). The efficacy was evaluated by randomized controlled trial involving a total of 66 patients. In 22 patients treated with immunosuppressive agents, the general efficacy rate was 19/22, the incidence rate of serious side-effect was 8/22. In 20 patients treated with 99Tc-MDP, the general efficacy rate was 17/20, the incidence rate of serious side-effect was 2/20. In 24 patients treated with immunosuppressive agents and 99Tc-MDP, the general efficacy rate was 22/24, the incidence rate of serious side-effect was 2/24. The results suggested that in the treatment of Graves' ophthalmopathy, when satisfactory efficacy was obtained, the serious side-effect and 'rebound' of symptom could be avoided by using immunosuppressive agents in combination with 99Tc-MDP.
Graves Ophthalmopathy ; drug therapy ; Humans ; Immunosuppressive Agents ; therapeutic use ; Technetium Tc 99m Medronate ; therapeutic use

Child ; Cyclophosphamide ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Nephrotic Syndrome ; drug therapy ; Treatment Outcome

Humans ; Tacrolimus/therapeutic use* ; Lupus Erythematosus, Systemic/drug therapy* ; Immunosuppressive Agents/therapeutic use* ; Treatment Outcome

Behcet's disease is characterized with multifactorial etiopathogenesis and multiclinical pictures. The treatment of patients with Behcet's disease is based on the severity of illness, and the most appropriate management of Behcet's disease requires a multidisciplinary approach. Although various therapeutic modalities have been employed for Behcet's disease, treatment is far from satisfactory. Treatment of Behcet's disease includes local, systemic, or surgical therapies. Limited success has been found with colchicine, azathioprine, indomethacin, cyclophosphamide, chlorambucil, levamisole, transfer factor, fibrinolytic therapy, and systemic corticosteroid. New therapeutic approaches have been introduced for Behcet's disease using cyclosporine, thalidomide, interferon, acyclovir, high-dose corticosteroids or cyclophosphamide pulse therapy, and FK 506. We suggest that therapeutic agents should be selected after thorough evaluation of the immune state of each patient by using various tests and by determining any aggravating or provoking factors involved. In general, a combination-agent regimen is more effective than a single-agent regimen. Early diagnosis and proper treatment can inhibit or at lease slow the progress of the disease remarkably.
Adrenal Cortex Hormones/therapeutic use ; Behcet's Syndrome/therapy* ; Cyclophosphamide/therapeutic use ; Human ; Immunosuppressive Agents/therapeutic use ; Tetracycline/therapeutic use ; Thalidomide/therapeutic use ; Zinc Sulfate/therapeutic use