Systematic Review On Multi-target Therapy For The Induction Treatment Of Severe Lupus Nephritis

Objectives:To evaluate the efficacy and safety of multi-target therapy(MT)and hormone combined cyclophosphamide(CTX)in the inducing treatment of severe lupus nephritis(SLN).Methods:All date were searched from Cochrane Library,PubMed,EMbase,Wanfang,and CNKI database.The literature were screened according to including and excluding standards,evaluated the quality of the included studies,and performed meta-analysis using RevMan 5.3 software.Results:Eight randomized controlled trials were included in this paper.Meta-analysis showed that MT had significantly superiority to IVC in the induction treatment of SLN[RR = 1.97,95%CI(1.64,2.37),P<0.00001],while with no significant advantage for the type ? and ?+? lupus nephritis(LN)patients.In addition,compared with CTX group,MT group could significantly reduce urine protein,increase serum albumin,the incidences of leukopenia and abnormal liver function were lower,the incidences of infection,gastrointestinal reactions,and new hypertension were no significant difference.Conclusion:MT is more effective for the treatment of type ?,?,and?+? LN than intravenous cyclophosphamide therapy(IVC)and with better security.