Therapy of tacrolimus combined with corticosteroids in idiopathic membranous nephropathy

Abstract

We evaluated the efficacy and safety of tacrolimus (TAC) combined with corticosteroids in treating patients with idiopathic membranous nephropathy (IMN). One hundred seventy-seven biopsy-proven IMN patients were recruited in this retrospective clinical study. Sixty patients received TAC (target blood concentration of 4–8 ng/mL) and 117 patients received daily cyclophosphamide (CYC, 100 mg) combined with prednisone. Remission rates at the end of the first, second and third month in the TAC group were significantly higher than that in the CYC group (1st: 35.0 vs 19.7%, P<0.05; 2nd: 56.7 vs 38.5%, P<0.05; 3rd: 76.7 vs 59.0%, P<0.05). In the first 3 months, daily urinary protein and serum albumin in the TAC group obtained a better improvement than that in the CYC group (P<0.05). At the end of the sixth and the twelfth month, the remission rates, daily urinary protein and serum albumin were all comparable between the two groups (P>0.05). No significant difference of relapse rate between the groups was found (16.3 vs 12.0%, P>0.05). Patients were more likely to develop glucose intolerance in the TAC group. The TAC regimen obtained more benefits in treating IMN patients, especially in the first 3 months, than the CYC regimen.

Efficacy and safety of tacrolimus‐based treatment for nephrotic idiopathic membranous nephropathy in young adults: A retrospective study

“…TR rates in the TAC group and TAC + Pred group were 77.5% and 80.4%, respectively. TR rates in both groups at the 12th month follow‐up were similar and satisfying, and the results are consistent with previous studies . The above results were further confirmed by multivariate logistic regression.…”

“…A number of studies have shown that TAC, either monotherapy or in combination with corticosteroids, was effective in treating IMN patients . In clinical practice, TAC based regimen has been preferred by young adults nowadays.…”

“…12 A number of studies have shown that TAC, either monotherapy or in combination with corticosteroids, was effective in treating IMN patients. [13][14][15][16] In clinical practice, TAC based regimen has been preferred by young adults nowadays. However, no study has been done on TAC treatment among young patients with nephrotic IMN.…”

Chlormethine Hydrochloride is Not Inferior to Tacrolimus in Treating Steroid-Resistant Nephrotic Syndrome

“…The difference in the infection incidence between the CHL group and the TAC group was not significant (P > 0.10). In addition, a slightly higher proportion of nausea and vomiting was found in the CHL group (11,15.3%) than found in the TAC group (5, 6.8%), with a P value of the c 2 test of 0.099. More details are shown in Table 5 and Fig.…”

“…Recently, studies have demonstrated the significant efficacy of nitrogen mustard or TAC in treating patients with idiopathic membranous nephropathy (IMN) [14][15][16], which showed a significant remission with a reduction in proteinuria or plasma creatinine in IMN patients and a reduced probability of developing end-stage renal disease [17,18]. Additionally, existing evidence supports the use of a combination of steroid and alkylating agents, such as nitrogen mustard [19].…”