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Clin Exp Rheumatol. 2010 Jan-Feb;28(1):6-12.

Tacrolimus is effective for lupus nephritis patients with persistent proteinuria.

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1
Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, and Department of Internal Medicine, Fukuoka University Hospital, Fukuoka, Japan.

Abstract

OBJECTIVES:

To evaluate the safety and potential efficacy of tacrolimus for the treatment of patients with lupus nephritis and persistent proteinuria.

METHODS:

A total of 23 Japanese patients with lupus nephritis (21 females/2 males) were enrolled in this study. Patients were administered tacrolimus at a dose of 2-3 mg once daily after the evening meal for 6 months. The dose of tacrolimus was unchanged throughout the study period. Concomitant prednisolone therapy was unchanged or gradually tapered, while other immunosuppressants were stopped at the start of tacrolimus treatment.

RESULTS:

Tacrolimus was well tolerated, and none of the patients developed adverse drug reactions that required discontinuation of the study. Daily urinary protein loss, the U-prot/U-creat ratio, and serum albumin were significantly improved after 4 months, 3 months, and 1 month of treatment with tacrolimus (p<0.05), respectively, and the improvement persisted until 6 months. The serum complement hemolytic activity (CH50), complement C3 level, and CRP level were also significantly improved after treatment with tacrolimus (p<0.05). Improvement of the U-prot/U-creat ratio was most prominent for patients who were in WHO class IV.

CONCLUSIONS:

Tacrolimus is safe and effective as maintenance therapy for patients with lupus nephritis, at least for 6 months. A larger randomised, controlled trial over a longer period is needed to confirm these results.

PMID:
20346231
[Indexed for MEDLINE]
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