Zhou Tianbiao, Lin Shujun, Yang Shen, Lin Wenshan
Department of Nephrology, The Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China,
Department of Nephrology, Huadu District People's Hospital of Guangzhou, Southern Medical University, Guangzhou 510800, China.
Drug Des Devel Ther. 2019 Mar 12;13:857-869. doi: 10.2147/DDDT.S189156. eCollection 2019.
The purpose of this study was to detect the efficacy and safety of tacrolimus (TAC) in induction therapy of patients with lupus nephritis.
Associated studies were extracted from the PubMed and the Cochrane Library on July 10, 2018, and applicable investigations were pooled and analyzed by meta-analysis. Data on complete remission (CR), total remission (TR; complete plus partial remission), proteinuria levels, urine erythrocyte number, albumin, glomerular filtration rate, negative rate of ds-DNA, C levels, C levels, systemic lupus erythematosus disease activity index (SLE-DAI), etc, were extracted and pooled using RevMan 5.3.
In the therapeutic regimen of TAC + glucocorticoids (GC) vs cyclophosphamide (CYC) + GC, the results indicated that the TAC group had high values of CR, TR, albumin, and negative rate of ds-DNA, and low values of proteinuria levels and SLE-DAI when compared with those in CYC group (all <0.05). In the therapeutic regimen comprising TAC + GC vs mycophenolate mofetil (MMF) + GC, the results indicated that the difference of CR, TR, proteinuria levels, and albumin between TAC group and MMF group were not significant (all >0.05). In the therapeutic regimen comprising TAC + MMF + GC vs CYC + GC, multitarget therapy group showed higher values of CR, TR, urinary protein decline, and rise of serum albumin when compared with CYC group (all <0.05).
TAC is an effective and safe agent in induction therapy of patients with lupus nephritis.
本研究旨在检测他克莫司（TAC）在狼疮性肾炎患者诱导治疗中的疗效和安全性。
于2018年7月10日从PubMed和Cochrane图书馆中提取相关研究，并通过荟萃分析对适用的调查进行汇总和分析。使用RevMan 5.3提取并汇总完全缓解（CR）、总缓解（TR；完全缓解加部分缓解）、蛋白尿水平、尿红细胞数量、白蛋白、肾小球滤过率、双链DNA阴性率、补体C水平、补体C水平、系统性红斑狼疮疾病活动指数（SLE-DAI）等数据。
在TAC+糖皮质激素（GC）与环磷酰胺（CYC）+GC的治疗方案中，结果表明，与CYC组相比，TAC组CR、TR、白蛋白和双链DNA阴性率较高，蛋白尿水平和SLE-DAI较低（均<0.05）。在TAC+GC与霉酚酸酯（MMF）+GC的治疗方案中，结果表明，TAC组与MMF组在CR、TR、蛋白尿水平和白蛋白方面的差异不显著（均>0.05）。在TAC+MMF+GC与CYC+GC的治疗方案中，多靶点治疗组与CYC组相比，CR、TR、尿蛋白下降和血清白蛋白升高的值更高（均<0.05）。
TAC是狼疮性肾炎患者诱导治疗中一种有效且安全的药物。
