TY - JOUR
T1 - Efficacy and safety of tacrolimus in patients with rheumatoid arthritis–A systematic review and meta-analysis
AU - Kaneko, Yuko
AU - Kawahito, Yutaka
AU - Kojima, Masayo
AU - Nakayama, Takeo
AU - Hirata, Shintaro
AU - Kishimoto, Mitsumasa
AU - Endo, Hirahito
AU - Seto, Yohei
AU - Ito, Hiromu
AU - Nishida, Keiichiro
AU - Matsushita, Isao
AU - Kojima, Toshihisa
AU - Kamatani, Naoyuki
AU - Tsutani, Kiichiro
AU - Igarashi, Ataru
AU - Hasegawa, Mieko
AU - Miyasaka, Nobuyuki
AU - Yamanaka, Hisashi
N1 - Funding Information:
YukK has received grants or speaking fees from AbbVie, Astellas, Ayumi, Bristol–Myers Squibb, Chugai, Eisai, Eli Lilly, Hisamitsu, Jansen, Kissei, Kirin, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, and UCB. YutK has received research grants and speaking fees from Astellas Pharma Inc. MaK has nothing to be declared. TN has nothing to be declared. SH has received grants, lecture fees or speaking fees from AbbVie, Astellas Pharam, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Jansen, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, UCB. MiK has received honoraria from Astellas Pharam. HE has nothing to be declared. YS has nothing to be declared. HI has received a research grant and/or speaker fee from Bristol-Myers, Astellas Pharam, Kyocera, and Asahi-Kasei. KN has nothing to be declared. IM has nothing to be declared. TK has nothing to be declared. NK has nothing to be declared.KT has nothing to be declared. AI has nothing to be declared. MH has received honoraria from Astellas Pharam. NM has nothing to be declared. HY has received grant from AbbVie, Eisai, Bristol-Meyers, Novartis, Behringer, Astellas, Kaken, Nippon-Shinyaku, Pfizer, UCB, Ayumi, Ono, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, YLbio, and speaker honorarium from Bristol-Meyers, Pfizer, Teijin Pharma, YLbio.
Funding Information:
A part of this work was supported by Health and Labor Sciences Research Grants for Research on Allergic Disease and Immunology from the Ministry of Health, Labor and Welfare (grant no. H23-Meneki-Shitei-016).
Publisher Copyright:
© 2020 Japan College of Rheumatology.
PY - 2021
Y1 - 2021
N2 - Objectives: To evaluate the efficacy and safety of tacrolimus in adult patients with rheumatoid arthritis (RA) by using the GRADE approach. Methods: We searched PubMed, Japana Centra Revuo Medicina Web (Ichu-shi web), and the Cochrane Database of Systematic Reviews. Articles fulfilling the predefined inclusion criteria were appraised and used for meta-analysis. The primary outcomes were American College of Rheumatology 20 (ACR20) and serum creatinine elevation. Other outcomes included ACR50, ACR70, changes in C-reactive protein, modified Health Assessment Questionnaire Disability Index, gastrointestinal disorders, metabolic and nutritional disorders, and infections and infestations. Results: We identified five randomized controlled studies, four of which compared tacrolimus to placebo and were included in the meta-analysis. The risk ratio of ACR20 achievement was 1.71 (95% confidence interval [CI] 1.20–2.42) for 1–2 mg/day and 2.30 (95% CI 1.79–2.96) for 3 mg/day. The risk ratio of creatinine elevation was 1.95 (95% CI 1.18–3.23) for 1–2 mg/day and 3.81 (95% CI 2.43–5.99) for 3 mg/day. Conclusion: Tacrolimus is effective with acceptable safety in the management of RA.
AB - Objectives: To evaluate the efficacy and safety of tacrolimus in adult patients with rheumatoid arthritis (RA) by using the GRADE approach. Methods: We searched PubMed, Japana Centra Revuo Medicina Web (Ichu-shi web), and the Cochrane Database of Systematic Reviews. Articles fulfilling the predefined inclusion criteria were appraised and used for meta-analysis. The primary outcomes were American College of Rheumatology 20 (ACR20) and serum creatinine elevation. Other outcomes included ACR50, ACR70, changes in C-reactive protein, modified Health Assessment Questionnaire Disability Index, gastrointestinal disorders, metabolic and nutritional disorders, and infections and infestations. Results: We identified five randomized controlled studies, four of which compared tacrolimus to placebo and were included in the meta-analysis. The risk ratio of ACR20 achievement was 1.71 (95% confidence interval [CI] 1.20–2.42) for 1–2 mg/day and 2.30 (95% CI 1.79–2.96) for 3 mg/day. The risk ratio of creatinine elevation was 1.95 (95% CI 1.18–3.23) for 1–2 mg/day and 3.81 (95% CI 2.43–5.99) for 3 mg/day. Conclusion: Tacrolimus is effective with acceptable safety in the management of RA.
KW - Conventional synthetic disease-modifying antirheumatic drug
KW - rheumatoid arthritis
KW - systematic review
KW - tacrolimus
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U2 - 10.1080/14397595.2020.1719607
DO - 10.1080/14397595.2020.1719607
M3 - Article
C2 - 31960737
AN - SCOPUS:85079122649
SN - 1439-7595
VL - 31
SP - 61
EP - 69
JO - Modern rheumatology
JF - Modern rheumatology
IS - 1
ER -