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Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis
OBJECTIVE: The objective of this meta-analysis was to compare the efficacy and safety of tacrolimus (TAC) monotherapy versus TAC-corticosteroid combination therapy in idiopathic membranous nephropathy (IMN) patients. METHODS: Databases including PubMed, Embase, the Cochrane Library, China National K...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702145/ https://www.ncbi.nlm.nih.gov/pubmed/34941086 http://dx.doi.org/10.1097/MD.0000000000028225 |
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author | Gong, Lifeng Xu, Min Xu, Wei Tang, Weigang Lu, Jingkui Jiang, Wei Xie, Fengyan Ding, Liping Qian, Xiaoli |
author_facet | Gong, Lifeng Xu, Min Xu, Wei Tang, Weigang Lu, Jingkui Jiang, Wei Xie, Fengyan Ding, Liping Qian, Xiaoli |
author_sort | Gong, Lifeng |
collection | PubMed |
description | OBJECTIVE: The objective of this meta-analysis was to compare the efficacy and safety of tacrolimus (TAC) monotherapy versus TAC-corticosteroid combination therapy in idiopathic membranous nephropathy (IMN) patients. METHODS: Databases including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from inception to January 10, 2021. Eligible studies comparing TAC monotherapy and TAC-corticosteroid combination therapy in IMN patients were included. Data were analysed using Review Manager Version 5.3. RESULTS: Seven studies were included in the meta-analysis. One randomized controlled trial and six cohort studies involving 372 patients were identified. Compared with TAC monotherapy, TAC-corticosteroid had a higher total remission at the sixth month (odd ratio (OR) 0.49, 95% confidence interval (CI) 0.31–0.78, P < .01). The two therapy regimens had similar complete remission rates (OR 0.79, 95% CI 0.43–1.48, P = .47) at the sixth month and similar relapse rates (OR 1.44, 95% CI 0.70–2.92, P = .32). TAC-corticosteroid combination therapy had a higher incidence of infection (OR 0.38, 95% CI 0.18–0.81, P = .01). The two therapy regimens had similar incidences of gastrointestinal symptoms (OR 0.96, 95% CI 0.34–2.70, P = .93), abnormal aminotransferase (OR 0.90, 95% CI 0.34–2.38, P = .84), and glucose intolerance (OR 0.58, 95% CI 0.32–1.07, P = .08). CONCLUSION: TAC-corticosteroid combination therapy had a higher total remission rate at the sixth month but had a higher incidence of infection than TAC monotherapy in the treatment of IMN. The two therapeutic regimens had similar relapse rates. |
format | Online Article Text |
id | pubmed-8702145 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-87021452021-12-27 Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis Gong, Lifeng Xu, Min Xu, Wei Tang, Weigang Lu, Jingkui Jiang, Wei Xie, Fengyan Ding, Liping Qian, Xiaoli Medicine (Baltimore) 5200 OBJECTIVE: The objective of this meta-analysis was to compare the efficacy and safety of tacrolimus (TAC) monotherapy versus TAC-corticosteroid combination therapy in idiopathic membranous nephropathy (IMN) patients. METHODS: Databases including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang database were searched from inception to January 10, 2021. Eligible studies comparing TAC monotherapy and TAC-corticosteroid combination therapy in IMN patients were included. Data were analysed using Review Manager Version 5.3. RESULTS: Seven studies were included in the meta-analysis. One randomized controlled trial and six cohort studies involving 372 patients were identified. Compared with TAC monotherapy, TAC-corticosteroid had a higher total remission at the sixth month (odd ratio (OR) 0.49, 95% confidence interval (CI) 0.31–0.78, P < .01). The two therapy regimens had similar complete remission rates (OR 0.79, 95% CI 0.43–1.48, P = .47) at the sixth month and similar relapse rates (OR 1.44, 95% CI 0.70–2.92, P = .32). TAC-corticosteroid combination therapy had a higher incidence of infection (OR 0.38, 95% CI 0.18–0.81, P = .01). The two therapy regimens had similar incidences of gastrointestinal symptoms (OR 0.96, 95% CI 0.34–2.70, P = .93), abnormal aminotransferase (OR 0.90, 95% CI 0.34–2.38, P = .84), and glucose intolerance (OR 0.58, 95% CI 0.32–1.07, P = .08). CONCLUSION: TAC-corticosteroid combination therapy had a higher total remission rate at the sixth month but had a higher incidence of infection than TAC monotherapy in the treatment of IMN. The two therapeutic regimens had similar relapse rates. Lippincott Williams & Wilkins 2021-12-23 /pmc/articles/PMC8702145/ /pubmed/34941086 http://dx.doi.org/10.1097/MD.0000000000028225 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 5200 Gong, Lifeng Xu, Min Xu, Wei Tang, Weigang Lu, Jingkui Jiang, Wei Xie, Fengyan Ding, Liping Qian, Xiaoli Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis |
title | Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis |
title_full | Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis |
title_fullStr | Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis |
title_full_unstemmed | Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis |
title_short | Efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: A meta-analysis |
title_sort | efficacy and safety of tacrolimus monotherapy versus tacrolimus-corticosteroid combination therapy for idiopathic membranous nephropathy: a meta-analysis |
topic | 5200 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702145/ https://www.ncbi.nlm.nih.gov/pubmed/34941086 http://dx.doi.org/10.1097/MD.0000000000028225 |
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