title: Comparison of tripterygium wilfordii multiglycosides and tacrolimus in the treatment of idiopathic membranous nephropathy: a prospective cohort study.
abstract: BACKGROUND
  Idiopathic membranous nephropathy (IMN) is a major cause of nephrotic syndrome among adults. Considering the natural course of IMN, when to treat and with which immunosuppressive treatment need to be carefully considered in such patients. A combination of tripterygium wilfordii multiglycosides (TWG) and prednisone may be an effective option for treating patients with IMN.
  
  
  METHODS
  In this prospective cohort study, we enrolled patients with biopsy-proven IMN at our kidney centre. One cohort received TWG combined with prednisone, whereas another cohort received tacrolimus (TAC) combined with prednisone, for 36 weeks. The primary outcome was the remission rate, whereas the secondary outcomes included the time to remission, relapse rate, changes in serum albumin levels and daily urinary protein levels, estimated glomerular filtration rate, and adverse events.
  
  
  RESULTS
  A total of 53 patients with IMN met the criteria for enrollment, and all patients completed the therapy. At the end of the 36-week therapy, remission (either partial remission [PR] or complete remission [CR]) was observed in 20 patients (86.9 %) receiving TWG and in 27 patients (90.0 %) receiving TAC (p > 0.05), whereas CR was noted in 12 patients (52.2 %) receiving TWG and 14 patients (46.7 %) receiving TAC (p > 0.05). The probability of remission was similar for both the TWG and TAC groups (p > 0.05, by log-bank test). The mean time for achieving remission was 11.8 ± 12.5 weeks in the TWG group and 8.5 ± 9.1 weeks in the TAC group (p > 0.05).
  
  
  CONCLUSIONS
  The combination of TWG and predisone is an effective and safe therapy for IMN.
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. 383038284@qq.com.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Liu
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. xyxy1313@sina.com.
authors.forename: Xiayu
authors.initials: X
authors.lastname: Li
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. hengliu75@139.com.
authors.forename: Heng
authors.initials: H
authors.lastname: Li
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. liangqian8238@163.com.
authors.forename: Qian
authors.initials: Q
authors.lastname: Liang
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. chenjunwood@gmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. chenjianghua@zju.edu.cn.
authors.forename: Jianghua
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis*; D006027:Glycosides / Q000008:administration & dosage*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods*; D011446:Prospective Studies; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D029757:Tripterygium / Q000737:chemistry*
chemical_list: D004365:Drugs, Chinese Herbal; D006027:Glycosides; D007166:Immunosuppressive Agents; D016559:Tacrolimus