• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Nephrology

Oral tacrolimus noninferior to intravenous cyclophosphamide for lupus nephritis

byIva OkajandAlex Chan
April 27, 2022
in Nephrology, Rheumatology
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Oral tacrolimus was noninferior to intravenous cyclophosphamide for lupus nephritis disease measures with lower toxicity.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Lupus nephritis is a common complication of systemic lupus erythematosus, occurring in a majority of patients (as many as 60%). The existing standard of care includes intravenous cyclophosphamide, carry significant adverse effects and cytotoxic risk. Tacrolimus, a calcineurin inhibitor that prevents T-cell activation and downstream autoantibody production, has demonstrated efficacy in randomized controlled trials with lower toxicity. Despite this evidence, it has not been compared with cyclophosphamide in any large-scale trials. This phase 3 multicenter randomized controlled trial randomized 157 patients in China to a tacrolimus group and 142 to receive IV cyclophosphamide. The primary outcome was the number of patients who received a complete or partial response in kidney function at week 24. Secondary outcomes included the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, immune parameters and kidney function parameters. Tacrolimus resulted in a complete or partial response rate comparable to the IV cyclophosphamide group, while adverse effects were less frequent in the tacrolimus group.

Click here to read the study in JAMA

Relevant Reading: Efficacy and safety of tacrolimus for lupus nephritis: A placebo-controlled double-blind multicenter study

In-Depth [Randomized controlled trial]: This study recruited patients aged 18 to 60 years with systemic lupus erythematosus and lupus nephritis classes III to V from 35 centers in China. The study ran from March 10, 2015 to September 13, 2018. Eligible and willing patients were recruited from outpatient settings. Inclusion criteria included body mass indices of 18.5 to 27, 24-hour urine protein greater than 1.5 g and serum creatinine of less than 260 μmol/L. In terms of the treatment, all patients received intravenous methylprednisolone 0.5 g/d for 3 days prior to starting study treatment, followed by oral prednisone at 0.8 mg/kg/d for 4 weeks tapered to a maintenance dose of 10 mg/d until 24 weeks.Tacrolimus dosing was initiated at 4 mg/d while IV cyclophosphamide was initiated at 0.75 mg/2 body surface area followed by 0.5 to 1.0 g/m2 every 4 weeks. Patients were assessed at weeks 1,2,4,8,12,16,20 and 24. During the trial, 7 patients withdrew due to adverse effects while 7 withdrew their consent. Tacrolimus resulted in a complete or partial response rate comparable to the IV cyclophosphamide group (83.0% and 75.0%, respectively); difference, 7.1% (2-sided 95% CI -2.7% to 16.9). The SLEDAI was -8.6 with tacrolimus at 24 weeks and -6.4 with IV cyclophosphamide (difference, -2.2; 95% CI, -3.1 to -1.3). Treatment-emergent adverse events (TEAEs) were recorded and considered serious if they resulted in threats to a patient’s life, disability, or hospitalization. The most common TEAEs were upper respiratory tract infection (n=37, 23.6%) in the tacrolimus group and leukopenia (n=16, 11.3%) in the IV cyclosporine group. Adverse effects were less frequent in the tacrolimus group (18.5%, compared to 24.6%). Serious TEAEs were reported in18.5% and 24.6% of patients in either group, respectively. In total, there were 2 treatment-related deaths while 7 patients withdrew from the study following adverse effects.

Image: PD

RELATED REPORTS

Radiofrequency renal denervation produces long-lasting reductions in blood pressure

Iberdomide elicits SRI-4 response in patients with systemic lupus erythematosus

2 Minute Medicine Rewind February 28, 2022

©2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: Lupusnephrology
Previous Post

#VisualAbstract: Ruxolitinib use may be associated with higher incidences of nonmelanoma skin cancers

Next Post

#VisualAbstract: Fewer hospital admissions and death were seen with SARS-CoV-2 Delta (B.1.617.2) compared to Omicron (B.1.1.529) variant infections

RelatedReports

Tenofovir disoprovil fumarate HIV prophylaxis linked with minimal kidney impact
Cardiology

Radiofrequency renal denervation produces long-lasting reductions in blood pressure

April 20, 2022
Multidrug induction therapy increases remission from lupus nephritis
Chronic Disease

Iberdomide elicits SRI-4 response in patients with systemic lupus erythematosus

March 21, 2022
Ticagrelor reversal agent provides immediate and sustained effect
Weekly Rewinds

2 Minute Medicine Rewind February 28, 2022

February 28, 2022
Compliance-linked incentives increase infant immunizations rates in rural India
Nephrology

No Difference in Antibody or Humoral Responses Among Kidney Transplant Recipients Vaccinated with a 3rd Dose of mRNA or Adenovirus Vector Vaccine

May 12, 2022
Next Post
#VisualAbstract: Fewer hospital admissions and death were seen with SARS-CoV-2 Delta (B.1.617.2) compared to Omicron (B.1.1.529) variant infections

#VisualAbstract: Fewer hospital admissions and death were seen with SARS-CoV-2 Delta (B.1.617.2) compared to Omicron (B.1.1.529) variant infections

Unenhanced magnetic resonance imaging highly sensitive and specific for acute appendicitis

Risks associated with nonoperative management of uncomplicated pediatric appendicitis

#VisualAbstract: Ruxolitinib use may be associated with higher incidences of nonmelanoma skin cancers

#VisualAbstract: Trastuzumab does not improve survival in patients with esophageal adenocarcinoma with HER2 overexpression

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • #VisualAbstract: Bimekizumab shows a favourable 2-year safety profile in patients with moderate to severe plaque psoriasis
  • Medical cannabis provides little improvement to sleep in chronic pain patients
  • Alzheimer disease in individuals with Down syndrome has similar variability in age of onset and mortality rate as autosomal dominant forms
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.