title: Co-administration of Wuzhi capsules and tacrolimus in patients with idiopathic membranous nephropathy: clinical efficacy and pharmacoeconomics.
abstract: OBJECTIVE
  Tacrolimus is an effective (but relatively expensive) immunosuppressant that is used widely in patients with membranous nephropathy. To reduce the tacrolimus dose while maintaining an equivalent therapeutic effect, we studied the clinical efficacy and pharmacoeconomic impact of co-administration of Wuzhi capsules (WZC that protects against damage to liver cells) and tacrolimus.
  
  
  METHODS
  Sixty patients with membranous nephropathy were divided randomly into two groups: experimental (tacrolimus + WZC + corticosteroids) and control (tacrolimus + corticosteroids). Each group received treatments continuously for >6 months. Liver function; renal function; and whole-blood concentrations of tacrolimus, sugars, lipids, as well as 24-h urinary protein levels were used in the clinical evaluation. The cost of drugs was calculated, and the pharmacoeconomic cost-effectiveness analyses were carried out to compare indices between the two groups.
  
  
  RESULTS
  Doses and costs of tacrolimus differed significantly between experimental and control groups (p < 0.01 or p < 0.05). Costs in the experimental group were 13,702.62 ± 1,458.6 CNY (2,194.10 ± 233.56 USD) and those in the control group were 17,796.87 ± 2,469.27 CNY (2,849.69 ± 395.39 USD), with clinical efficacy of 93.3 and 90.0 %, respectively. The cost-effectiveness ratios were 146.86 ± 15.63 and 197.73 ± 27.44, respectively. Compared with the experimental group, the control group showed an incremental cost-effectiveness ratio of 1,240.68 ± 306.25 CNY (198.66 ± 49.04 USD), whereas remission between the two groups was similar.
  
  
  CONCLUSIONS
  Co-administration of WZCs and tacrolimus can reduce the dose of tacrolimus and decrease the costs incurred by patients within the same therapeutic window to that seen for treatment with tacrolimus alone.
authors.affiliation: Department of Vascular Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Zhanfeng
authors.initials: Z
authors.lastname: Sun
authors.forename: Miaomiao
authors.initials: M
authors.lastname: Ren
authors.forename: Qiong
authors.initials: Q
authors.lastname: Wu
authors.forename: Xuanyi
authors.initials: X
authors.lastname: Du
mesh_terms: D000305:Adrenal Cortex Hormones / Q000191:economics / Q000627:therapeutic use; D000328:Adult; D001706:Biopsy; D002214:Capsules; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000191:economics* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017850:Economics, Pharmaceutical; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D016559:Tacrolimus / Q000191:economics* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D002214:Capsules; D004365:Drugs, Chinese Herbal; D007166:Immunosuppressive Agents; C582515:wuzhi; D016559:Tacrolimus