Authors: Linbo Zhu Linlin Liu Li Yao Lining Wang
Publish Date: 2017/01/13
Volume: 77, Issue: 2, Pages: 187-199
Abstract
We included four randomized controlled trials and two prospective cohort studies with 389 PMN patients The pooled results using the Dersimonian and Laird method showed that renal remission rates at the longest followup periods were not significantly different between the tacrolimus and cyclophosphamide groups overall remission six trials n = 389 relative risk RR 0994 95 confidence interval CI 0768–1286 complete remission six trials n = 389 RR 1256 95 CI 0733–2150 Further analyses found that tacrolimus was comparable with cyclophosphamide for inducing renal remission within 1 year but inferior to cyclophosphamide after 1year followup It should be noted that only two studies reported the outcomes after 1year followup which might be considered as weak evidence The rates of relapse and the dropouts due to adverse effects were not significantly different relapse six trials n = 389 RR 2244 95 CI 0892–5644 dropouts six trials n = 389 RR 1330 95 CI 0412–4291 However the cyclophosphamide group had a significantly higher risk of leukopenia than the tacrolimus group four trials n = 216 RR 0203 95 CI 0045–0916 whereas the rates of tremor were significantly higher in the tacrolimus group than in the cyclophosphamide group three trials n = 202 RR 8939 95 CI 1694–47173Tacrolimus was comparable with cyclophosphamide for inducing renal remission of PMN patients within 1 year but the longterm effects need to be investigated The cyclophosphamide group had a significantly higher risk of leukopenia whereas the tacrolimus group had significantly higher rates of tremor These conclusions need to be further verified
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