Efficacy and safety of tacrolimus combined with glucocorticoid treatment for IgA nephropathy: a meta-analysis

OBJECTIVE: As a classical immunosuppressant, tacrolimus (TAC) has been widely used in organ transplantation therapy, but the general benefits of TAC for the treatment of IgA nephropathy (IgAN) remain uncertain. We conducted a meta-analysis to examine the effects of TAC combined with glucocorticoid on IgAN. METHODS: We searched the information databases PubMed/Medline, Embase, Science Citation Index, Chinese Biomedical Literature and the Chinese databases VIP, CNKI and Wan Fang for randomized controlled trials of TAC combined with glucocorticoid as a therapy for IgAN. RESULTS: Ten relevant studies involving 472 patients were included in a meta-analysis. Overall, the TAC group showed a significant decrease in proteinuria compared with the control group (MD: −0.18 g/d, 95% CI: −0.32 to −0.04). No increased risk of adverse events was observed (OR: 0.93, 95% CI: 0.65 to 1.33). In general, the TAC group showed good tolerance. CONCLUSION: Evidence to date clearly indicates that TAC combined with glucocorticoid is quite effective in reducing proteinuria and albuminuria in patients with IgAN. Moreover, we found that patients receiving TAC therapy did not show an increased risk of side effects compared with control group patients. TAC combined with glucocorticoid is a promising medication and merits further research.