A meta-analysis of multiple targets with cyclophosphamide in the induction treatment of lupus nephritis / 重庆医学

ABSTRACT

Objective To evaluate efficacy and safety of hormone combined mycophenolate mofetil (MMF) and tacrolimus (FK506) multiple targets treatment ,hormone combined intravenous cyclophosphamide pulse (IVC ) in the induction treatment of lupus nephritis .Methods The RCTs of MMF plus FK506 versus IVC in LN were searched from PubMed ,EMbase ,the Cochrane , CBM ,and CNKI .The literature were screened according to include and exclude standards ,evaluated the quality of the included stud-ies ,and performed meta-analyses using Revman 5 .1 software .Results It was identified 44 domestic RCTs papers including 331 pa-tients .Meta-analysis showed that multiple target therapy group had significantly superiority to IVC group in the induction treatment of Ⅴ + Ⅳ LN (RR=3 .94 ,95% CI 2 .10-7 .38 ,P<0 .01) ,while with no significant advantage for other pathological types of LN patients .Gastrointestinal reaction ,abnormal liver function ,the incidence of leukopenia ,menstrual disorders in multiple target thera-py group were significantly lower than that of IVC group for LN ,while the incidence of new hypertension group was significantly higher than the IVC group .Moreover ,multiple target therapy group could significantly reduce urine protein ,increase serum albumin and had a significantly higher anti-dsDNA negative conversion rate compared with IVC group .Conclusion Multiple target therapy is more effective than IVC for Ⅴ + Ⅳ LN in Chinese patients and with better security .Further large-scale RCTs are needed to con-firm these results .