【文摘发布】霉酚酸酯用于重症狼疮性肾炎诱导和维持治疗：对随机对照临床实验的荟萃分析
发布于 2007-04-17 · 浏览 1397 · IP 湖北湖北
这个帖子发布于 17 年零 349 天前，其中的信息可能已发生改变或有所发展。
Title:Mycophenolate mofetil in induction and maintenance therapy of severe lupus nephritis: a meta-analysis of randomized controlled trials.
Author:Zhu B, Chen N, Lin Y, Ren H, Zhang W, Wang W, Pan X, Yu H
Resource:Nephrol Dial Transplant. 2007Apr3
BACKGROUND: The outcomes of previous trials of mycophenolate mofetil (MMF) in treating severe lupus nephritis (LN) are not in exact agreement. This meta-analysis of randomized controlled trials (RCTs) assesses the benefits and harms of MMF in the induction and maintenance therapy of severe LN. METHODS: We searched Medline, EMBASE and the Cochrane Collaboration Database for RCTs that compared MMF with other immunorepressive regimens for treating lupus nephritis and extracted data for remissions, side effects and prognosis in induction therapy and prognosis and side effects in maintenance therapy, and we summarized the combined results of the data of the RCTs as relative risk (RR). RESULTS: We analysed five RCTs with 307 patients-four RCTS providing the data for comparing MMF with cyclophosphamide (CYC) for induction therapy and two RCTs providing the data for comparing MMF with azathioprine (AZA) for maintenance therapy of severe LN. Overall, compared with CYC, induction therapy with MMF reduced the risk of infection significantly (RR 0.65, P < 0.001). It also significantly increased the complete remission rate compared with intravenous CYC (RR 3.10, P = 0.006). Compared with intravenous CYC, induction therapy with MMF reduced the incidence of leucopenia significantly (RR 0.66, P = 0.04). The prognosis and other side effects were not significantly different between MMF and CYC induction therapies. There was no significant difference between the patients receiving MMF and those receiving AZA for maintenance therapy in prognosis or the risks of amenorrhoea and herpes zoster. CONCLUSIONS: MMF has higher efficacy in inducing remission in severe LN than pulsed intravenous therapy with CYC. Induction therapy with MMF is also associated with fewer side effects than induction therapy with CYC. Compared with AZA, MMF also is an alternative for maintenance therapy of severe LN without significant difference in the prognosis or risks of amenorrhoea and herpes zoster.
PMID: 17405792
Author:Zhu B, Chen N, Lin Y, Ren H, Zhang W, Wang W, Pan X, Yu H
Resource:Nephrol Dial Transplant. 2007Apr3
BACKGROUND: The outcomes of previous trials of mycophenolate mofetil (MMF) in treating severe lupus nephritis (LN) are not in exact agreement. This meta-analysis of randomized controlled trials (RCTs) assesses the benefits and harms of MMF in the induction and maintenance therapy of severe LN. METHODS: We searched Medline, EMBASE and the Cochrane Collaboration Database for RCTs that compared MMF with other immunorepressive regimens for treating lupus nephritis and extracted data for remissions, side effects and prognosis in induction therapy and prognosis and side effects in maintenance therapy, and we summarized the combined results of the data of the RCTs as relative risk (RR). RESULTS: We analysed five RCTs with 307 patients-four RCTS providing the data for comparing MMF with cyclophosphamide (CYC) for induction therapy and two RCTs providing the data for comparing MMF with azathioprine (AZA) for maintenance therapy of severe LN. Overall, compared with CYC, induction therapy with MMF reduced the risk of infection significantly (RR 0.65, P < 0.001). It also significantly increased the complete remission rate compared with intravenous CYC (RR 3.10, P = 0.006). Compared with intravenous CYC, induction therapy with MMF reduced the incidence of leucopenia significantly (RR 0.66, P = 0.04). The prognosis and other side effects were not significantly different between MMF and CYC induction therapies. There was no significant difference between the patients receiving MMF and those receiving AZA for maintenance therapy in prognosis or the risks of amenorrhoea and herpes zoster. CONCLUSIONS: MMF has higher efficacy in inducing remission in severe LN than pulsed intravenous therapy with CYC. Induction therapy with MMF is also associated with fewer side effects than induction therapy with CYC. Compared with AZA, MMF also is an alternative for maintenance therapy of severe LN without significant difference in the prognosis or risks of amenorrhoea and herpes zoster.
PMID: 17405792
最后编辑于 2022-10-09 · 浏览 1397
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