Department of Medicine, Kidney Center,Tokyo Women's Medical University, Tokyo, Japan.
Nephron Clin Pract. 2009;113(4):c330-6. doi: 10.1159/000235952. Epub 2009 Sep 3.
BACKGROUND/AIMS: The purpose of this study was to examine whether tacrolimus is effective and safe, and to determine the optimal dose of tacrolimus for maintenance treatment in patients with lupus nephritis (LN).
A total of 17 adult patients (1 man and 16 women) with LN were enrolled. Tacrolimus was initiated at a dose of 3 mg/day which was administered once per day after the evening meal. Prospective data on renal response and serologic lupus activity were collected and followed for a year.
Mean age at baseline was 48.8 +/- 12.6 years (range 31-72 years). The mean urinary protein/creatinine ratio significantly decreased from 1.14 +/- 1.74 at baseline to 0.23 +/- 0.47 at 1 year (p < 0.05). Mean serum C3 significantly increased from 73.0 +/- 12.3 mg/dl at baseline to 84.7 +/- 12.2 mg/dl at 1 year (p < 0.01). Mean serum creatinine levels were unchanged after tacrolimus treatment. The mean blood concentration of tacrolimus was 3.9 +/- 2.1 ng/ml. There was no relationship between the incidence of adverse effects and blood tacrolimus level.
Our results suggest tacrolimus to be potentially effective and safe for maintenance treatment in patients with LN.
背景/目的:本研究旨在探讨他克莫司(tacrolimus)在狼疮肾炎(LN)患者维持治疗中的疗效和安全性,以及确定其最佳剂量。
共纳入 17 例 LN 成年患者(1 例男性,16 例女性)。他克莫司起始剂量为 3mg/天,每日晚餐后 1 次口服。前瞻性收集肾脏应答和血清狼疮活动的相关数据,并随访 1 年。
基线时患者的平均年龄为 48.8±12.6 岁(范围 31-72 岁)。尿蛋白/肌酐比值从基线时的 1.14±1.74 显著下降至 1 年时的 0.23±0.47(p<0.05)。血清 C3 平均水平从基线时的 73.0±12.3mg/dl 显著增加至 1 年时的 84.7±12.2mg/dl(p<0.01)。他克莫司治疗后血清肌酐水平无变化。他克莫司的平均血药浓度为 3.9±2.1ng/ml。不良反应的发生率与血药浓度之间无相关性。
本研究结果提示他克莫司对 LN 患者的维持治疗具有潜在的疗效和安全性。