{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:46:51Z","timestamp":1790725611773,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n We have previously reported the mid\u2010term efficacy and safety of tacrolimus (Tac)\u2010based immunosuppressive therapy in such patients, and herein, we aimed to determine their long\u2010term outcomes (over 10\u2009years).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively evaluate the data of 13 consecutive patients with biopsy\u2010proven long\u2010standing LN who underwent a long\u2010term Tac\u2010based treatment regimen. Tac was administered once daily at a dose of 3\u2009mg as reinduction or maintenance treatment. Treatment outcomes were defined using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), urinary protein\/creatinine ratio (Up\/cr), serum creatinine, estimated glomerular filtration rate (eGFR) and serological lupus markers (complement C3, complement hemolytic activity [CH 50], and anti\u2010dsDNA antibody titre), and the concomitantly administered prednisolone (PDN) dose. Data on clinical parameters and serological lupus activity were collected annually from each patient throughout the study period.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The patients' baseline characteristics at the treatment initiation were as follows: mean age, 18\u2009years; Up\/cr, 0.63\u2009\u00b1\u20090.69; serum C3 level, 57.2\u2009\u00b1\u200922.4\u2009mg\/dL (normal range, 79\u2013152\u2009mg\/dL); CH50, 27.9\u2009\u00b1\u200915.7\u2009U\/mL (normal range, 23.0\u201346.0\u2009U\/mL); serum anti\u2010dsDNA antibody titre, 111.7\u2009\u00b1\u2009123.4\u2009IU\/mL (normal range, <12.0\u2009IU\/mL); serum creatinine, 0.60\u2009\u00b1\u20090.19\u2009mg\/dL; eGFR, 115.6\u2009\u00b1\u200921.3\u2009mL\/min and SLEDAI, 13\u2009\u00b1\u20098.1. Despite the gradual tapering of the concomitantly administered PDN dose from 18.7\u2009\u00b1\u200913.5\u2009mg\/day at baseline to 3.5\u2009\u00b1\u20092.8\u2009mg\/day at 10\u2009years (\n p<\/jats:italic>\n \u2009=\u2009.002), a marked improvement in the outcomes, compared with the baseline values, was observed within a year. Additionally, these favourable changes persisted throughout study period in most patients. Compared with the baseline values, the following measures confirmed sustained outcome improvements after a 10\u2010year treatment: SLEDAI, 1.7\u2009\u00b1\u20092.0; serum C3 level, 83.8\u2009\u00b1\u200916.1\u2009mg\/dL; CH50, 45.6\u2009\u00b1 10.9\u2009U\/mL (all\n p<\/jats:italic>\n \u2009<\u2009.01) and Up\/cr, 0.16\u2009\u00b1\u20090.18 and serum anti\u2010dsDNA antibody titre, 25.8\u2009\u00b1\u200928.8\u2009IU\/mL (both\n p<\/jats:italic>\n \u2009<\u2009.05). Serum creatinine level and eGFR remained within the normal range in all study participants except for one patient who experienced several flare\u2010ups. No serious adverse effects were observed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our results suggest that long\u2010term Tac\u2010based immunosuppressive treatment as maintenance therapy is beneficial and has low cytotoxicity. Therefore, it represents an attractive option for the treatment of selected patients with paediatric\u2010onset LN in a real\u2010world setting.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nep.14406","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T04:43:27Z","timestamp":1729485807000},"page":"901-908","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Long\u2010term outcome of tacrolimus\u2010based immunosuppressive treatment for patients with paediatric\u2010onset lupus nephritis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7057-813X","authenticated-orcid":false,"given":"Hiroshi","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Health and Medical Care Hachinohe Gakuin University Hachinohe Japan"},{"name":"Department of School Health Science Hirosaki University Faculty of Education Hirosaki Japan"},{"name":"Department of Pediatrics Hirosaki University Hospital Hirosaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1425-1017","authenticated-orcid":false,"given":"Tomomi","family":"Aizawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hirosaki University Hospital Hirosaki Japan"},{"name":"Niji\u2010iro Children's Clinic Hirosaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morito","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health and Medical Care Hachinohe Gakuin University Hachinohe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0141-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S363722"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-216924"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.12419"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12136"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000430458"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu265"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-018-4154-6"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000346149"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.09.006"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00259.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v1.i6.177"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-017-1381-1"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.191008"},{"key":"e_1_2_10_16_1","article-title":"Long\u2010term 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