Efficacy and safety of tacrolimus in patients with rheumatoid arthritis – A systematic review and meta-analysis. Issue 1 (2nd January 2021)

• Record Type: Journal Article
• Authors: Kaneko, Yuko; Kawahito, Yutaka; Kojima, Masayo; Nakayama, Takeo; Hirata, Shintaro; Kishimoto, Mitsumasa; Endo, Hirahito; Seto, Yohei; Ito, Hiromu; Nishida, Keiichiro; Matsushita, Isao; Kojima, Toshihisa; Kamatani, Naoyuki; Tsutani, Kiichiro; Igarashi, Ataru; Hasegawa, Mieko; Miyasaka, Nobuyuki; Yamanaka, Hisashi
• Is Part Of: Modern rheumatology. Volume 31:Issue 1(2021)
• Page Start: 61
• Page End: 69
• Publication Date: 2021-01-02
• Subjects: Conventional synthetic disease-modifying antirheumatic drug -- rheumatoid arthritis -- systematic review -- tacrolimus; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1080/14397595.2020.1719607
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objectives: To evaluate the efficacy and safety of tacrolimus in adult patients with rheumatoid arthritis (RA) by using the GRADE approach. Methods: We searched PubMed, Japana Centra Revuo Medicina Web (Ichu-shi web), and the Cochrane Database of Systematic Reviews. Articles fulfilling the predefined inclusion criteria were appraised and used for meta-analysis. The primary outcomes were American College of Rheumatology 20 (ACR20) and serum creatinine elevation. Other outcomes included ACR50, ACR70, changes in C-reactive protein, modified Health Assessment Questionnaire Disability Index, gastrointestinal disorders, metabolic and nutritional disorders, and infections and infestations. Results: We identified five randomized controlled studies, four of which compared tacrolimus to placebo and were included in the meta-analysis. The risk ratio of ACR20 achievement was 1.71 (95% confidence interval [CI] 1.20–2.42) for 1–2 mg/day and 2.30 (95% CI 1.79–2.96) for 3 mg/day. The risk ratio of creatinine elevation was 1.95 (95% CI 1.18–3.23) for 1–2 mg/day and 3.81 (95% CI 2.43–5.99) for 3 mg/day. Conclusion: Tacrolimus is effective with acceptable safety in the management of RA.