Impact of Tacrolimus Versus Cyclosporine on Overall Response, Complete Remission and Relapse in Nephrotic Syndrome: A Systematic Review and Meta-Analysis

Zhenjie Jin, Jia Sun and Wen Zhang

Background and Objective: Nephrotic syndrome requires effective treatment to reduce symptoms and prevent recurrence. As immunosuppressants, tacrolimus and cyclosporine are commonly used, although research on their efficacy and outcomes is continuing. Patients diagnosed with nephrotic syndrome were included in this meta-analysis to determine the impact that immunosuppressants such as tacrolimus and cyclosporine have on the overall response, full remission and recurrence of the condition. Materials and Methods: The Embase, PubMed and Cochrane Library databases were searched to do this systematic review and meta-analysis. Using predefined criteria, records were screened for relevance, the risk of bias was assessed with Cochrane and Newcastle-Ottawa tools and data was extracted for meta-analysis. The included studies were limited to those comparing tacrolimus with cyclosporine in nephrotic syndrome patients regarding overall response, complete remission and relapse rates. Results: The qualitative and quantitative synthesis comprised 8 investigations. The meta-analysis of the overall response, complete remission and relapse yielded no statistically significant difference between tacrolimus and cyclosporine. The relative risk (RR) for overall response was 1.03 (95% CI [0.97, 1.10], p = 0.34; for complete remission, 1.1057 (95% CI [0.9986, 1.2244], p = 0.05) and for relapse was 1.17 (95% CI [0.79, 1.74], p = 0.43). The entire response data displayed a minimal probability of publication bias, as indicated by the funnel plot. Conclusion: This examination found no significant difference in nephrotic syndrome response, complete remission or recurrence rates between tacrolimus and cyclosporine. These findings suggest that patient environment and clinical factors may affect drug choice. Investigating these outcomes requires further research and high-quality investigations.

View Fulltext Back