The efficacy of add-on tacrolimus for minor flare in patients with systemic lupus erythematosus

A retrospective study

Haruki Watanabe, R. Yamanaka, Kenei Sada, S. Zeggar, E. Katsuyama, T. Katsuyama, M. T. Narazaki, N. T. Tatebe, K. Sugiyama, K. S. Watanabe, H. Wakabayashi, T. Kawabata, Jun Wada, Hirofumi Makino

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective We have assessed the effectiveness of tacrolimus for minor flares in systemic lupus erythematosus (SLE) patients. Methods The medical records of 313 patients were retrospectively reviewed over a period of seven years, from 2006 to 2013. We enrolled patients with minor flare treated with add-on tacrolimus, without glucocorticoid (GC) intensification (tacrolimus group). Minor flare was defined as a ≥1-point increase in a total score between 3 and 11 in the SLE Disease Activity Index (SLEDAI). We enrolled as controls patients who were administered increased doses of GC for minor flare (GC group). All patients were followed for one year. The primary outcome measure was the proportion of responders. Results There were 14 eligible patients in the tacrolimus group and 20 eligible patients in the GC group. The mean SLEDAI at flare tended to be higher in the tacrolimus group than in the GC group (7.5 vs. 6.2, p = 0.085). A mean dose of 1.6 mg tacrolimus/day was administered for flare, while the mean GC dose was 13.7 mg/day in the GC group. The proportion of responders was 86% (12/14) in the tacrolimus group and 75% (15/20) in the GC group (p = 0.67). The mean dose of GC at 12 months was higher in the GC group than in the tacrolimus group (9.7 mg/day vs. 7.1 mg/day, p <0.05). Only one patient discontinued tacrolimus because of fatigue after three months. Conclusion Adding tacrolimus without increasing the GC dose may provide an effective treatment option for minor flares in patients with SLE.

Original languageEnglish
Pages (from-to)54-60
Number of pages7
JournalLupus
Volume25
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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Tacrolimus
Systemic Lupus Erythematosus
Glucocorticoids
Retrospective Studies
Medical Records
Fatigue
Outcome Assessment (Health Care)

Keywords

  • minor flare
  • systemic lupus erythematosus
  • Tacrolimus

ASJC Scopus subject areas

  • Rheumatology

Cite this

The efficacy of add-on tacrolimus for minor flare in patients with systemic lupus erythematosus : A retrospective study. / Watanabe, Haruki; Yamanaka, R.; Sada, Kenei; Zeggar, S.; Katsuyama, E.; Katsuyama, T.; Narazaki, M. T.; Tatebe, N. T.; Sugiyama, K.; Watanabe, K. S.; Wakabayashi, H.; Kawabata, T.; Wada, Jun; Makino, Hirofumi.

In: Lupus, Vol. 25, No. 1, 01.01.2016, p. 54-60.

Research output: Contribution to journalArticle

Watanabe, H, Yamanaka, R, Sada, K, Zeggar, S, Katsuyama, E, Katsuyama, T, Narazaki, MT, Tatebe, NT, Sugiyama, K, Watanabe, KS, Wakabayashi, H, Kawabata, T, Wada, J & Makino, H 2016, 'The efficacy of add-on tacrolimus for minor flare in patients with systemic lupus erythematosus: A retrospective study', Lupus, vol. 25, no. 1, pp. 54-60. https://doi.org/10.1177/0961203315600538
Watanabe, Haruki ; Yamanaka, R. ; Sada, Kenei ; Zeggar, S. ; Katsuyama, E. ; Katsuyama, T. ; Narazaki, M. T. ; Tatebe, N. T. ; Sugiyama, K. ; Watanabe, K. S. ; Wakabayashi, H. ; Kawabata, T. ; Wada, Jun ; Makino, Hirofumi. / The efficacy of add-on tacrolimus for minor flare in patients with systemic lupus erythematosus : A retrospective study. In: Lupus. 2016 ; Vol. 25, No. 1. pp. 54-60.
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abstract = "Objective We have assessed the effectiveness of tacrolimus for minor flares in systemic lupus erythematosus (SLE) patients. Methods The medical records of 313 patients were retrospectively reviewed over a period of seven years, from 2006 to 2013. We enrolled patients with minor flare treated with add-on tacrolimus, without glucocorticoid (GC) intensification (tacrolimus group). Minor flare was defined as a ≥1-point increase in a total score between 3 and 11 in the SLE Disease Activity Index (SLEDAI). We enrolled as controls patients who were administered increased doses of GC for minor flare (GC group). All patients were followed for one year. The primary outcome measure was the proportion of responders. Results There were 14 eligible patients in the tacrolimus group and 20 eligible patients in the GC group. The mean SLEDAI at flare tended to be higher in the tacrolimus group than in the GC group (7.5 vs. 6.2, p = 0.085). A mean dose of 1.6 mg tacrolimus/day was administered for flare, while the mean GC dose was 13.7 mg/day in the GC group. The proportion of responders was 86{\%} (12/14) in the tacrolimus group and 75{\%} (15/20) in the GC group (p = 0.67). The mean dose of GC at 12 months was higher in the GC group than in the tacrolimus group (9.7 mg/day vs. 7.1 mg/day, p <0.05). Only one patient discontinued tacrolimus because of fatigue after three months. Conclusion Adding tacrolimus without increasing the GC dose may provide an effective treatment option for minor flares in patients with SLE.",
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AU - Watanabe, Haruki

AU - Yamanaka, R.

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AU - Zeggar, S.

AU - Katsuyama, E.

AU - Katsuyama, T.

AU - Narazaki, M. T.

AU - Tatebe, N. T.

AU - Sugiyama, K.

AU - Watanabe, K. S.

AU - Wakabayashi, H.

AU - Kawabata, T.

AU - Wada, Jun

AU - Makino, Hirofumi

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N2 - Objective We have assessed the effectiveness of tacrolimus for minor flares in systemic lupus erythematosus (SLE) patients. Methods The medical records of 313 patients were retrospectively reviewed over a period of seven years, from 2006 to 2013. We enrolled patients with minor flare treated with add-on tacrolimus, without glucocorticoid (GC) intensification (tacrolimus group). Minor flare was defined as a ≥1-point increase in a total score between 3 and 11 in the SLE Disease Activity Index (SLEDAI). We enrolled as controls patients who were administered increased doses of GC for minor flare (GC group). All patients were followed for one year. The primary outcome measure was the proportion of responders. Results There were 14 eligible patients in the tacrolimus group and 20 eligible patients in the GC group. The mean SLEDAI at flare tended to be higher in the tacrolimus group than in the GC group (7.5 vs. 6.2, p = 0.085). A mean dose of 1.6 mg tacrolimus/day was administered for flare, while the mean GC dose was 13.7 mg/day in the GC group. The proportion of responders was 86% (12/14) in the tacrolimus group and 75% (15/20) in the GC group (p = 0.67). The mean dose of GC at 12 months was higher in the GC group than in the tacrolimus group (9.7 mg/day vs. 7.1 mg/day, p <0.05). Only one patient discontinued tacrolimus because of fatigue after three months. Conclusion Adding tacrolimus without increasing the GC dose may provide an effective treatment option for minor flares in patients with SLE.

AB - Objective We have assessed the effectiveness of tacrolimus for minor flares in systemic lupus erythematosus (SLE) patients. Methods The medical records of 313 patients were retrospectively reviewed over a period of seven years, from 2006 to 2013. We enrolled patients with minor flare treated with add-on tacrolimus, without glucocorticoid (GC) intensification (tacrolimus group). Minor flare was defined as a ≥1-point increase in a total score between 3 and 11 in the SLE Disease Activity Index (SLEDAI). We enrolled as controls patients who were administered increased doses of GC for minor flare (GC group). All patients were followed for one year. The primary outcome measure was the proportion of responders. Results There were 14 eligible patients in the tacrolimus group and 20 eligible patients in the GC group. The mean SLEDAI at flare tended to be higher in the tacrolimus group than in the GC group (7.5 vs. 6.2, p = 0.085). A mean dose of 1.6 mg tacrolimus/day was administered for flare, while the mean GC dose was 13.7 mg/day in the GC group. The proportion of responders was 86% (12/14) in the tacrolimus group and 75% (15/20) in the GC group (p = 0.67). The mean dose of GC at 12 months was higher in the GC group than in the tacrolimus group (9.7 mg/day vs. 7.1 mg/day, p <0.05). Only one patient discontinued tacrolimus because of fatigue after three months. Conclusion Adding tacrolimus without increasing the GC dose may provide an effective treatment option for minor flares in patients with SLE.

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