The short term efficacy of tacrolimus and cyclophosphamide in the treatment of lupus nephritis
JIANG Wenzhi
LIU Yali
ZHAO Shuanghong
ZHANG Jiufeng
LIU Zhuo
CHEN Xin
Abstract：Objective To compare the efficacy and safety of tacrolimus and cyclophosphamide in the treatment of lupus nephritis.Methods 186 patients with lupus nephritis who underwent renal surgery in Xi’an 141 Hospital from November 2013 to October 2016 were selected as subjects.The patients were randomized arranged to tacrolimus treatment group (n=93) and cyclophosphamide treatment group (n=93).The tacrolimus group patients was administered intravenously with tacrolimus at a dose of 0.05 mg·kg-1·d-1 twice daily,and continued titration until 12 hours valley concentration of 5-10 ng/ml.The cyclophosphamide patients group received intravenous injection of cyclophosphamide,the initial dose of 750 mg/m2,every 4 weeks to adjust 500-1 000 mg/m2.Both groups were given prednisone at the initial dose of 1 mg·kg-1·d-1.All patients were treated for 6 months.The clinical efficacy and laboratory indicators: serum urinary protein,serum albumin,serum creatinine,serum complement C3 and systemic lupus erythematosus disease activity index (SLEDAI),adverse reactions were observed.Results After 6 months of treatment,the complete remission rate (51.6% vs.35.5%,χ2=6.921,P=0.027) and the effective rate (91.4% vs 78.5%,χ2=7.508,P=0.011) were significantly higher in the tacrolimus group than in the cyclophosphamide group.After 1 month of treatment,the urinary protein was significantly lower in the tacrolimus group than in the cyclophosphamide group[(2.80±0.64) g/24h vs.(3.72±0.95) g/24h,t=7.745,P=0.000].The level of complement C3 in tacrolimus group was significantly higher than that in cyclophosphamide group [(986.0±193.8) mg/L vs.(862.7±146.3) mg/L,t=5.030,P=0.021] after 6 months of induction therapy.The proportion of patients with leukopenia and gastrointestinal symptoms (χ2=6.866,χ2=7.359,P=0.026,P=0.014) was lower in the tacrolimus group.Conclusion Tacrolimus combined with prednisone in the treatment of lupus nephritis is superior to cyclophosphamide combined with prednisone and more safe.
Keywords：Lupus nephritisTacrolimusCyclophosphamideEfficacy
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1001-1005,1009 )