Efficacy and safety of tacrolimus versus cyclophosphamide therapy for Henoch-Schönlein purpura nephritis in children: A systematic review.

BACKGROUND

This systematic review studied and compared the safety and efficacy of glucocorticoids (GCs) + cyclophosphamide (CTX) and GCs + tacrolimus (TAC) therapies for treating children with Henoch-Schönlein purpura nephritis (HSPN).

METHODS

The data on GCs + CTX and GCs + TAC therapies for HSPN children were procured from the EMbase, China National Knowledge Infrastructure, the Cochrane Library, PubMed, and Wanfang from the inception to May 10, 2024.

RESULTS

This review included 5 studies (2 non-randomized and 3 randomized controlled trials), comprising 363 patients. Furthermore, the complete remission within 6 months in the TAC group (43.3%) was higher than that in CTX group (26.2%) and the total remission within 6 months in the TAC (76.7%) was higher than that in CTX groups (54.1%). Moreover, in terms of adverse reactions, the incidence of hypertension in TAC group was higher than that in CTX group, whereas the incidences of other adverse reactions such as liver function injury, hyperglycemia, myelosuppression and gastrointestinal discomfort in TAC group were lower than that in CTX group.

CONCLUSION

This systematic review indicated that for HSPN children, the TAC therapy may have relatively higher remission rate and fewer adverse reactions than the CTX therapy.