Efficacy and Safety of Tacrolimus vs. Cyclophosphamide for Idiopathic Membranous Nephropathy： A Meta-analysis of Chinese Adults

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences 2015-10, Vol.35 (5), p.623-628
• Main Author: 李贞琼 胡曼丽 张春 王玉梅
• Format: Article
• Language: English
• Subjects: Adult; Asian Continental Ancestry Group; Cyclophosphamide - therapeutic use; Female; Glomerular Basement Membrane - drug effects; Glomerular Basement Membrane - immunology; Glomerular Basement Membrane - pathology; Glomerulonephritis, Membranous - drug therapy; Glomerulonephritis, Membranous - ethnology; Glomerulonephritis, Membranous - immunology; Glomerulonephritis, Membranous - pathology; Humans; Immunosuppressive Agents - therapeutic use; Male; Medicine; Medicine & Public Health; Patient Safety; PubMed; Randomized Controlled Trials as Topic; Tacrolimus - therapeutic use; Treatment Outcome; 中文数据库; 安全性分析; 治疗方案; 环磷酰胺; 疗效; 肾病; 随机对照试验
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-015-1480-8

The efficacy and safety of tacrolimus （TAC） and cyclophosphamide （CTX） in the treatment of idiopathic membranous nephropathy （IMN） were compared in Chinese adult patients using a meta-analysis of the available literatures. Randomized controlled clinical trials （RCTs） of the treatment of primary IMN with TAC or CTX combined with corticosteroids in the English databases PubMed, Embase and Cochrane, as well as Chinese databases, were searched. Qualified studies were subjected to quality assessment and meta-analysis. A total of 8 RCTs, including 359 Chinese patients, were included in the meta-analysis. The complete remission rate and overall remission rate in the TAC treatment group after 6 months of treatment were higher than those in the CTX treatment group. No significant difference in remission rate was found after 12 months of treatment. There was no significant difference in the adverse reaction between the two groups at the 6th or 12th months. TAC-based treatment was associated with a faster response than CTX at the 6th month, but there was no significant difference between the two groups at 12th month in Chinese adults. Further study is needed to evaluate the long-term efficacy and safety of this treatment regimen.