Meta-analysis of calcineurin inhibitor vs.cyclophosphamide in the treatment of idiopathic membranous nephropathy
Objective To objectively evaluate the efficacy and safety of calcineurin inhibitors,including tacrolimus and cyclosporine A(CsA),vs.cyclophosphamide(CTX) in treating idiopathic membranous nephropathy(IMN).Methods By methods of Cochrane systematic review,databases including Chinese Journal full-text...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Department of Journal of Clinical Nephrology
2015-01-01
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| Series: | Linchuang shenzangbing zazhi |
| Subjects: | |
| Online Access: | http://www.lcszb.com/thesisDetails?columnId=57920595&Fpath=home&index=0 |
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| Summary: | Objective To objectively evaluate the efficacy and safety of calcineurin inhibitors,including tacrolimus and cyclosporine A(CsA),vs.cyclophosphamide(CTX) in treating idiopathic membranous nephropathy(IMN).Methods By methods of Cochrane systematic review,databases including Chinese Journal full-text Database,Weipu Database,Wanfang Database,PubMed,MEDLINE,and Cochrane Library were searched till October of 2014,and manual retrieval was employed meanwhile.Homogeneous data that met the inclusion criteria were analyzed by RevMan 5.0 software.Results Twelve randomized controlled trials(RCT) meeting the inclusion criteria were enrolled.The total remission rate and complete remission rate were higher(P<0.05),and the incidence rate of hepatic dysfunction,leukocytopenia and infection was lower in tacrolimus group than in CTX group(P<0.05),but there was no statistically significant difference in the incidence rate of glucose intolerance and gastrointestinal syndrome between the two groups(P>0.05).Between CsA group and CTX group,no statistically significant difference was found regarding to the total remission rate and complete remission rate(P>0.05),while the incidence rate of hepatic dysfunction,leukocytopenia,and gastrointestinal syndrome was lower in CsA group than in CTX group(P<0.05).Conclusions Calcineurin inhibitor can significantly increase the total remission rate and complete remission rate in IMN patients,tacrolimus is more effective than CTX,and CsA has similar effectiveness with CTX Moreover,calcineurin inhibitor has less incidence rate of adverse effects than CTX.However,large scale,multicentered,well-designed randomized controlled trials should be adopted to further confirm the conclusions. |
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| ISSN: | 1671-2390 |