Multitarget Therapy for Induction Treatment of Lupus Nephritis

• DOI: 10.7326/m14-1030
• Publication Date: 2014-11-10T23:30:45Z
• Authors: Zhihong Liu; Haitao Zhang; Zhangsuo Liu; Changying Xing; Ping Fu; Zhaohui Ni; Jianghua Chen; Hongli Lin; Fuyou Liu; Yongcheng He; Yani He; Lining Miao; Nan Chen; Ying Li; Yong Gu; Wei Shi; Weixin Hu; Zhengzhao Liu; Hao Bao; Caihong Zeng; Minlin Zhou
• Keywords: Clinical endpoint

Treatment of lupus nephritis (LN) remains challenging.To assess the efficacy and safety a multitarget therapy consisting tacrolimus, mycophenolate mofetil, steroid compared with intravenous cyclophosphamide as induction for LN.24-week randomized, open-label, multicenter study. (ClinicalTrials.gov: NCT00876616).26 renal centers in China.Adults (aged 18 to 65 years) biopsy-proven LN.Tacrolimus, 4 mg/d, 1.0 g/d, versus starting dose 0.75 (adjusted 0.5 1.0) g/m2 body surface area every weeks 6 months. Both groups received 3 days pulse methylprednisolone followed by tapering course oral prednisone therapy.The primary end point was complete remission at 24 weeks. Secondary points included overall response (complete partial remission), time response, adverse events.After therapy, more patients group (45.9%) than (25.6%) showed (difference, 20.3 percentage [95% CI, 10.0 30.6 points]; P < 0.001). The incidence higher (83.5% vs. 63.0%; difference, 20.4 [CI, 10.3 0.001), median shorter -4.1 -7.9 -2.1 weeks]). Incidence events did not differ between (50.3% [91 181] 52.5% [95 181]).The study limited follow-up.Multitarget provides superior LN.National Basic Research Program China, National Key Technology R&D Program.