title: Tacrolimus therapy for systemic lupus erythematosus without renal involvement: a preliminary retrospective study.
abstract: We conducted a pilot study to investigate whether tacrolimus was effective for treating patients with systemic lupus erythematosus (SLE) without renal involvement. Ten SLE patients with symptoms such as arthritis and erythema, but no active nephritis, were treated with tacrolimus. They included 8 women and 2 men aged from 24 to 62 years [mean +/- standard deviation (SD): 42.1 +/- 11.3 years]. Tacrolimus was administered at doses of 1-3 mg daily, and efficacy was assessed from the SLE Disease Activity Index (SLEDAI) after 1 year. Two patients ceased treatment due to adverse reactions (after 4 days for chest pain and 7 months for recurrent infections). The other 8 patients completed 1 year of treatment, and significant improvement of disease activity was observed in 6 of them. The mean (+/-SD) SLEDAI showed a significant decrease after 1 year of tacrolimus therapy, from 6.8 +/- 3.1 to 3.4 +/- 0.9; p < 0.05 by Student's paired t test. The mean (+/-SD) dose of prednisolone also decreased significantly, from 16.8 +/- 8.6 to 9.3 +/- 4.6 mg/day; p < 0.05. Although a prospective controlled study will be necessary to confirm, tacrolimus might be a treatment option for active SLE without renal involvement.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Kusunoki
authors.forename: Nahoko
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kaichi
authors.initials: K
authors.lastname: Kaneko
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Hirahito
authors.initials: H
authors.lastname: Endo
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kawai
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003176:Complement C3 / Q000378:metabolism; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010865:Pilot Projects; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D003176:Complement C3; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D011239:Prednisolone; D016559:Tacrolimus