ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2018, Vol. 27 ›› Issue (5): 424-429.DOI: 10.3969/j.issn.1006-298X.2018.05.005

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Efficacy and safety of calcineurin inhibitors as induction therapy for lupus nephritis:a systematic review and metaanalysis

  

  • Online:2018-10-28 Published:2018-11-14

Abstract:

Objective:There is growing interest in the role of calcineurin inhibitors (CNIs) in lupus nephritis (LN) induction treatments.The study aimed to evaluate the efficacy and safety of CNIs as induction treatment for LN by metaanalysis.
Methodology:PubMed,EMBASE,Cochrane Central Register of Controlled Trials (CENTRAL),and three Chinese databases (WanFang Data,Chongqing VIP and China National Knowledge Infrastructure) were searched for all human studies in induction  treatment of LN with CNIs up to September 2017.Randomized controlled trials (RCTs) comparing the efficacy and safety of CNIs with other drugs in LN patients were included.Statistical analyses were performed using Stata12 software.
Results:A total of sixteen studies involving 871 patients were included in this study.CNIs had significant merits in increasing total remission (P<0001) and complete remission (P<0001).The incidences of infection,gastrointestinal discomfort,leukopenia and  menstrual disorder were higher in control group,whereas the incidences of hypertension,transient creatinine elevation and abnormal glucose metabolism were higher in CNIs group.
Conclusion:
Our systematic review demonstrates that CNIs are promising alternatives for LN patients,primarily due to their better shortterm efficacy and safety.Welldesigned clinical trials are needed to further evaluate the longterm efficacy and safety of CNIs.

 

Key words: calcineurin inhibitors, lupus nephritis, induction therapy, meta-analysis