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Cited 2 time in webofscience Cited 2 time in scopus
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Multitarget therapy versus monotherapy as induction treatment for lupus nephritis: A meta-analysis of randomized controlled trials

Authors
Lee, Young HoSong, Gwan Gyu
Issue Date
Oct-2022
Publisher
SAGE Publications
Keywords
Tacrolimus; voclosporin; multitarget therapy; lupus nephritis; meta-analysis
Citation
Lupus, v.31, no.12, pp 1468 - 1476
Pages
9
Indexed
SCIE
SCOPUS
Journal Title
Lupus
Volume
31
Number
12
Start Page
1468
End Page
1476
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61399
DOI
10.1177/09612033221122148
ISSN
0961-2033
1477-0962
Abstract
Aim The safety of multitarget treatments is of concern. This study aimed to evaluate the effectiveness and safety of multitarget therapy as an induction treatment for lupus nephritis in comparison with monotherapy. Methods This study included randomized controlled trials (RCTs) that evaluated the effectiveness and safety of multitarget therapies, such as voclosporin+mycophenolate mofetil (MMF), tacrolimus+MMF, or belimumab+standard of care in comparison with MMF or cyclophosphamide (CYC) monotherapy for induction treatment of lupus nephritis. We performed a meta-analysis of the efficacy and safety of multitarget therapy as an induction treatment for lupus nephritis in comparison with monotherapy. Results Six RCTs, including 1,437 participants, met the inclusion criteria. The complete remission rate was significantly higher in the multitarget therapy group than in the monotherapy group (odds ratio, 2.155; 95% CI, 1.695–2.739; p < 0.001). Subgroup analysis revealed that the complete remission rate was significantly higher in both tacrolimus+MMF and voclosporin+MMF groups as well as the belimumab+standard of care (SOC) than in the monotherapy or SOC group. The incidence of adverse events did not differ between the multitarget therapy and monotherapy groups. However, cases of infection and pneumonia were numerically higher in the multitarget therapy group than in the monotherapy group. In addition, the incidence of menstrual disorder was significantly lower in the tacrolimus+MMF group than in the CYC group, whereas that of new-onset hypertension was considerably higher in the tacrolimus+MMF group than in the CYC group. Conclusions Multitarget therapy showed a higher complete remission rate than monotherapy; however, cases of infection and pneumonia were numerically more elevated in the multitarget therapy group than in the monotherapy group.
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Lee, Young Ho
Anam Hospital (Department of Rheumatology, Anam Hospital)
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