Efficacy of multitarget therapy with refractory idiopathic membranous nephropathy
Li Li
Guo Yuanyuan
Gou Rong
Li Qiouhong
Yang Zijun
Wang Liuwei
Tang Lin
Abstract：Objective Idiopathic membranous nephropathy (IMN) is a common cause of nephrotic syndrome (NS) in adults.This study was performed to observe the efficacy and side-effects of multitarget therapy in treating patients with refractory IMN.Methods Forty five patients with refractory idiopathic membranous nephropathy were recruited in this randomized controlled trial, 23 receiving multitarget therapy, including tacrolimus (Tac), mycophenolate mofetil (MMF) and low-dose steroids, while 22 receiving cyclophosphamide (CYC) and prednisone.The initial dose of Tac was 0.05 mg/(kg·d) combined with 1.0 g/d MMF, and the 24-hour through blood concentration (C0) of Tac was approximately 3~6 ng/ml.The CYC group received daily oral CYC 100 mg/d for 3 months (accumulated dosage was 9 g).Both groups received oral prednisone 0.5 mg/(kg·d) for 8 weeks and tapered gradually.Results Of the 40 patients who completed the 6-months treatment, theprobability of overall remission (CR and PR) was significantly higher in the multitarget group(75%) than in the CYC group (40%)(P=0.013).Furthermore, a significantly greater improvement in proteinuria was observed in the multitarget group compared with the CYC group.No obvious nephrotoxicity and other serious side-effects were found in the multitarget group.Conclusion In this trial, low-dose steroids combined with Tac and MMF are effective and safe in refractory IMN.The treatment of refractory cases with multitarget therapy is promising.
Keywords：idiopathic membranous nephropathymultitarget therapyTacrolimusMycophenolate mofetil
Publication Date：2017-01-01
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 1933-1936 )