%0 Journal Article
%T Effectiveness and safety of cyclophosphamide or tacrolimus therapy for idiopathic membranous nephropathy
%A Fang Jiang
%A Gaosi Xu
%A Honghong Zou
%J Renal Failure
%D 2019
%R https://doi.org/10.1080/0886022X.2019.1637758
%X Abstract Background: Guidelines recommend combined therapy of glucocorticoid and cyclophosphamide (CYC) for patients with idiopathic membranous nephropathy (IMN), while it is associated with severe adverse effects. We conducted a retrospective study to evaluate the effectiveness and safety of glucocorticoid plus tacrolimus (TAC) for IMN. Methods: Two hundred and three kidney-biopsy-proven IMN patients were enrolled in this study. One group (n£¿=£¿142) received glucocorticoid combined with intravenous CYC (750£¿mg/m2 body surface) and the other group (n£¿=£¿61) received glucocorticoid combined with oral TAC (target blood concentration of 4¨C8£¿ng/mL). The primary outcomes were achievement of remission and incidence of adverse events. The secondary end points included relapse rates, 24£¿h urinary protein (UP), serum albumin, serum creatinine and estimated glomerular filtration rate. Results: Over the 18-month observation period, the study suggested that the remission rates at the first 3£¿months were significantly higher in TAC group than in CYC group (72.1% versus 54.9%, p£¿<£¿.05). Although the cumulative incidence of serious and non-serious adverse events was not different significantly between the two groups, the incidence after first 3£¿months was lower in TAC group. 24hUP and serum albumin improved in TAC group more than the CYC group (p£¿<£¿.05) over the observed period. Conclusion: Because of its short-term effectiveness and long-term safety profile, glucocorticoid plus TAC might be a better option for IMN
%U https://www.tandfonline.com/doi/full/10.1080/0886022X.2019.1637758