Tacrolimus for induction therapy of diffuse proliferative lupus nephritis: An open-labeled pilot study

Mok, Chi Chiu; Tong, M.K.H.; To, Chi Hung; Siu, Yui-Pong; Au, Tak Cheung

doi:10.1111/j.1523-1755.2005.00461.x

Cited by 129 publications

(110 citation statements)

References 22 publications

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“…19 Tacrolimus can suppress IL-2 transcriptions, inhibit T cell activation, 20 decrease the production of TNF-␣ and IFN-␥, 21 and inhibit IL-10 production. 19,22,23 Although Nash et al 24 reported tacrolimus to reduce the GFR, neither our study nor the reports from Mok et al 25 and Tse et al 26 observed such an effect. This may be ascribed to a relatively lower dosage adopted in these studies (approximately 0.06 to 0.10 versus approximately 0.12 to 0.15 mg/kg per d).…”

Section: Discussioncontrasting

confidence: 81%

Successful Treatment of Class V+IV Lupus Nephritis with Multitarget Therapy

Bao

Liu

Xie

et al. 2008

Journal of the American Society of Nephrology

276

213

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Treatment of class VϩIV lupus nephritis remains unsatisfactory despite the progress made in the treatment of diffuse proliferative lupus nephritis. In this prospective study, 40 patients with class VϩIV lupus nephritis were randomly assigned to induction therapy with mycophenolate mofetil, tacrolimus, and steroids (multitarget therapy) or intravenous cyclophosphamide (IVCY). Patients were treated for 6 mo unless complete remission was not achieved, in which case treatment was extended to 9 mo. An intention-to-treat analysis revealed a higher rate of complete remission with multitarget therapy at both 6 and 9 mo (50 and 65%, respectively) than with IVCY (5 and 15%, respectively). At 6 mo, eight (40%) patients in each group experienced partial remission, and at 9 mo, six (30%) patients receiving multitarget therapy and eight (40%) patients receiving IVCY experienced partial remission. There were no deaths during this study. Most adverse events were less frequent in the multitarget therapy group. Calcineurin inhibitor nephrotoxicity was not observed, but three patients developed new-onset hypertension with multitarget therapy. In conclusion, multitarget therapy is superior to IVCY for inducing complete remission of class VϩIV lupus nephritis and is well tolerated.

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Section: Discussioncontrasting

confidence: 81%

Successful Treatment of Class V+IV Lupus Nephritis with Multitarget Therapy

Bao

Liu

Xie

et al. 2008

Journal of the American Society of Nephrology

276

213

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“…Tacrolimus has been used with success in severe focal segmental glomerulosclerosis (6,7), resistant membranous nephropathy (8) and lupus nephritis (9). Mycophenolate mofetil has been successfully used in membranous nephropathy (10,11), resistant minimal change disease (11,12), and focal segmental glomerulosclerosis (12).…”

Section: The Choice Of Immunosuppressive Medication Used After Kidneymentioning

confidence: 99%

Impact of Immunosuppressive Medication on the Risk of Renal Allograft Failure due to Recurrent Glomerulonephritis

Mulay

Walraven²,

Knoll

2009

American Journal of Transplantation

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Recurrent glomerulonephritis is a major problem in kidney transplantation but the role of immunosuppression in preventing this complication is not known. We used data from the United States Renal Data System to examine the effect of immunosuppressive medication on allograft failure due to recurrent glomerulonephritis for 41 272 patients undergoing kidney transplantation from 1990 to 2003. Ten-year incidence of graft loss due to recurrent glomerulonephritis was 2.6% (95% confidence interval [CI]: 2.3-2.8%). After adjusting for important covariates, the use of cyclosporine, tacrolimus, azathioprine, mycophenolate mofetil, sirolimus or prednisone was not associated with graft failure due to recurrent glomerulonephritis. There was no difference between cyclosporine and tacrolimus or between azathioprine and mycophenolate mofetil in the risk of graft failure due to recurrent glomerulonephritis. However, any change in immunosuppression during follow-up was independently associated with graft loss due to recurrence (adjusted hazard ratio 1.30, 95% CI: 1.06-1.58, p = 0.01). In patients with a pretransplant diagnosis of glomerulonephritis, the risk of graft loss due to recurrence was not associated with any specific immunosuppressive medication. The selection of immunosuppression for kidney transplant recipients should not be made with the goal of reducing graft failure due to recurrent glomerulonephritis.

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“…Indeed, to date several papers have described the efficacy and safety of Tac in patients with active SLE (Duddridge & Powell, 1997). Recently, Tac combined with PDN has been successfully administered without serious adverse effects, as induction and maintenance treatment for patients with proliferative and membranous lupus nephritis (Politt et al, 2004;Maruyama et al, 2005;Mok et al, 2005;Tse et al, 2007;Szeto et al, 2008). However, there is little information regarding the efficacy and safety of Tac in young patients with lupus nephritis (Tanaka et al, 2007a(Tanaka et al, , 2009).…”

Section: Tacrolimus a Calcineurin Inhibitormentioning

confidence: 99%

Treatment of Pediatric-Onset Lupus Nephritis: A New Option of Less Cytotoxic Immunosuppressive Therapy

Tanaka¹,

Imaizumi²

2011

Autoimmune Disorders - Current Concepts and Advances From Bedside to Mechanistic Insights

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Tacrolimus for induction therapy of diffuse proliferative lupus nephritis: An open-labeled pilot study

Abstract: Tacrolimus is an effective option for induction treatment of SLE-diffuse proliferative glomerulonephritis. Further trials are necessary to determine the optimal dosage and duration of therapy, and its efficacy in comparison to standard regimens.

Cited by 129 publications

References 22 publications

Successful Treatment of Class V+IV Lupus Nephritis with Multitarget Therapy

Successful Treatment of Class V+IV Lupus Nephritis with Multitarget Therapy

Impact of Immunosuppressive Medication on the Risk of Renal Allograft Failure due to Recurrent Glomerulonephritis

Treatment of Pediatric-Onset Lupus Nephritis: A New Option of Less Cytotoxic Immunosuppressive Therapy

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