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Induction and Maintenance Treatment of Lupus Nephritis: A Comprehensive Review of Meta-Analyses
- Title
- Induction and Maintenance Treatment of Lupus Nephritis: A Comprehensive Review of Meta-Analyses
- Authors
- Shin J.I.; Li H.; Park S.; Yang J.W.; Lee K.H.; Jo Y.; Oh J.; Kim H.; An H.J.; Jeong G.; Jung H.; Lee H.J.; Kim J.S.; Nam S.W.; Koyanagi A.; Jacob L.; Hwang J.; Yon D.K.; Lee S.-W.; Tizaoui K.; Kronbichler A.; Kim J.H.; Smith L.
- Ewha Authors
- 이현정
- SCOPUS Author ID
- 이현정
- Issue Date
- 2022
- Journal Title
- Journal of Clinical Medicine
- ISSN
- 2077-0383
- Citation
- Journal of Clinical Medicine vol. 11, no. 2
- Keywords
- Calcineurin inhibitor; End-stage kidney disease; Glucocorticoids; Lupus nephritis; Systemic lupus erythematosus
- Publisher
- MDPI
- Indexed
- SCIE; SCOPUS
- Document Type
- Review
- Abstract
- Background: Lupus nephritis (LN) is present in over 50% of patients with systemic lupus erythematosus (SLE) which is managed with immunosuppressive and immunomodulatory therapies. However, several novel therapeutic approaches for LN are under investigation due to the adverse effects spectrum of conventional therapy; Methods: We performed a comprehensive review of meta-analyses aggregating the comparative efficacies of various pharmacotherapies for LN. We conducted a literature search and retrieved a total of 23 meta-analyses and network metaanalyses for summarization. Pharmacotherapies were evaluated across six major outcomes: remission, relapse, mortality, end stage kidney disease (ESKD) progression, infection, and malignancy. Result: Calcineurin inhibitors (CNI), particularly tacrolimus (TAC), in combination with glucocorticoids (GC) outperformed cyclophosphamide (CPA) with GC in the rate of remission, either complete or partial remission, and in terms of infectious complications. In maintenance therapy, MMF was superior to azathioprine (AZA) as the MMF-treated patients had lower relapse rate. Interpretation: This review aggregates evidence of therapy for clinicians and sheds light on comparative efficacies of alternative LN treatments. As more promising agents are entering the market, such as voclosporin, belimumab, and obinutuzumab, LN management might undergo significant changes during the next years. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- DOI
- 10.3390/jcm11020343
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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