Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathy
In this study, we aimed to evaluate the efficacy and safety of tacrolimus-based treatment for immunoglobulin A nephropathy (IgAN). We retrospectively reviewed 127 adult patients with primary IgAN with 24 h urine total protein quantity (24 h UTP) ≥ 1 g and serum creatinine ≤3 mg/dL. All patients were...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-05-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1189608/full |
| _version_ | 1797824496491560960 |
|---|---|
| author | Lijuan Zhao Yanyan Yang Yanyan Yang Hao Xu Wei Leng Guoshuang Xu |
| author_facet | Lijuan Zhao Yanyan Yang Yanyan Yang Hao Xu Wei Leng Guoshuang Xu |
| author_sort | Lijuan Zhao |
| collection | DOAJ |
| description | In this study, we aimed to evaluate the efficacy and safety of tacrolimus-based treatment for immunoglobulin A nephropathy (IgAN). We retrospectively reviewed 127 adult patients with primary IgAN with 24 h urine total protein quantity (24 h UTP) ≥ 1 g and serum creatinine ≤3 mg/dL. All patients were divided into tacrolimus (TAC) and control (non-TAC) groups according to the treatment strategy. Proteinuria remission, remission rate, and adverse events were compared between the two groups. Among the 127 patients, 61 received TAC-based treatment and 66 received non-TAC treatment. TAC group exhibited a more rapid decline in proteinuria than the non-TAC group at 3, 9, and 12 months (p = 0.049, 0.001, and 0.018, respectively). Remission rates at 1, 3, 6, 9, and 12 months were 41.0, 68.9, 80.3, 90.2, and 88.5%, respectively, in the TAC group. These rates were higher than those in the control group at 3, 9, and 12 months (p = 0.030, 0.008, and 0.026, respectively). Complete remission rates at 1, 3, 6, 9, and 12 months were 6.56, 19.7, 37.7, 54.1, and 62.3%, respectively, in the TAC group. These rates were higher than those in the control group at 9 and 12 months (p = 0.013 and 0.008, respectively). The estimated mean time to complete remission was significantly shorter in the TAC group than in the control group (p = 0.028). TAC did not increase the incidence of adverse events. In conclusion, TAC accelerated proteinuria remission in patients with non-rapidly progressive IgAN with no increased risk of adverse events. Further prospective randomized controlled trials are necessary to validate our findings. |
| first_indexed | 2024-03-13T10:39:50Z |
| format | Article |
| id | doaj.art-31232c0ad99f4328ac853313ad329d9f |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-13T10:39:50Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-31232c0ad99f4328ac853313ad329d9f2023-05-18T04:57:19ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-05-011410.3389/fphar.2023.11896081189608Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathyLijuan Zhao0Yanyan Yang1Yanyan Yang2Hao Xu3Wei Leng4Guoshuang Xu5Department of Nephrology, Xijing Hospital, Fourth Military Medical University of PLA, Xi’an, ChinaDepartment of Nephrology, Xijing Hospital, Fourth Military Medical University of PLA, Xi’an, ChinaDepartment of Nephrology, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, ChinaM.S. in Biostatistics, Columbia University Mailman School of Public Health, New York, NY, United StatesDepartment of Nephrology, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, ChinaDepartment of Nephrology, Xijing Hospital, Fourth Military Medical University of PLA, Xi’an, ChinaIn this study, we aimed to evaluate the efficacy and safety of tacrolimus-based treatment for immunoglobulin A nephropathy (IgAN). We retrospectively reviewed 127 adult patients with primary IgAN with 24 h urine total protein quantity (24 h UTP) ≥ 1 g and serum creatinine ≤3 mg/dL. All patients were divided into tacrolimus (TAC) and control (non-TAC) groups according to the treatment strategy. Proteinuria remission, remission rate, and adverse events were compared between the two groups. Among the 127 patients, 61 received TAC-based treatment and 66 received non-TAC treatment. TAC group exhibited a more rapid decline in proteinuria than the non-TAC group at 3, 9, and 12 months (p = 0.049, 0.001, and 0.018, respectively). Remission rates at 1, 3, 6, 9, and 12 months were 41.0, 68.9, 80.3, 90.2, and 88.5%, respectively, in the TAC group. These rates were higher than those in the control group at 3, 9, and 12 months (p = 0.030, 0.008, and 0.026, respectively). Complete remission rates at 1, 3, 6, 9, and 12 months were 6.56, 19.7, 37.7, 54.1, and 62.3%, respectively, in the TAC group. These rates were higher than those in the control group at 9 and 12 months (p = 0.013 and 0.008, respectively). The estimated mean time to complete remission was significantly shorter in the TAC group than in the control group (p = 0.028). TAC did not increase the incidence of adverse events. In conclusion, TAC accelerated proteinuria remission in patients with non-rapidly progressive IgAN with no increased risk of adverse events. Further prospective randomized controlled trials are necessary to validate our findings.https://www.frontiersin.org/articles/10.3389/fphar.2023.1189608/fullIgA nephropathytacrolimusproteinuriaimmunosuppressive agentsadverse events |
| spellingShingle | Lijuan Zhao Yanyan Yang Yanyan Yang Hao Xu Wei Leng Guoshuang Xu Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathy Frontiers in Pharmacology IgA nephropathy tacrolimus proteinuria immunosuppressive agents adverse events |
| title | Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathy |
| title_full | Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathy |
| title_fullStr | Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathy |
| title_full_unstemmed | Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathy |
| title_short | Efficacy and safety of tacrolimus-based treatment for non-rapidly progressive IgA nephropathy |
| title_sort | efficacy and safety of tacrolimus based treatment for non rapidly progressive iga nephropathy |
| topic | IgA nephropathy tacrolimus proteinuria immunosuppressive agents adverse events |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1189608/full |
| work_keys_str_mv | AT lijuanzhao efficacyandsafetyoftacrolimusbasedtreatmentfornonrapidlyprogressiveiganephropathy AT yanyanyang efficacyandsafetyoftacrolimusbasedtreatmentfornonrapidlyprogressiveiganephropathy AT yanyanyang efficacyandsafetyoftacrolimusbasedtreatmentfornonrapidlyprogressiveiganephropathy AT haoxu efficacyandsafetyoftacrolimusbasedtreatmentfornonrapidlyprogressiveiganephropathy AT weileng efficacyandsafetyoftacrolimusbasedtreatmentfornonrapidlyprogressiveiganephropathy AT guoshuangxu efficacyandsafetyoftacrolimusbasedtreatmentfornonrapidlyprogressiveiganephropathy |