{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:44:06Z","timestamp":1788399846636,"version":"build-2803163510"},"reference-count":75,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,19]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to compare the effectiveness of 13 types of immunosuppressive agents used to treat idiopathic membranous nephropathy (IMN) in adults with nephrotic syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and network meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed, EMbase, Cochrane Library, Web of Science, Clinical trials, SinoMed, Chinese Biomedicine, CNKI, WanFang and Chongqing VIP Information databases were comprehensively searched until February 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Randomised clinical trials (RCTs) comparing the effects of different immunosuppressive treatments in adult patients with IMN and nephrotic syndrome were included, and all included RCTs had a study-duration of at least 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Two reviewers independently screened articles, extracted data and assessed study quality. Standard pairwise meta-analysis was performed using DerSimonian-Laird random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study ultimately included 48 RCTs with 2736 patients and 13 immunosuppressive agents. The network meta-analysis results showed that most regimens, except for leflunomide (LEF), mizoribine (MZB) and steroids (STE), showed significantly higher probabilities of total remission (TR) when compared with non-immunosuppressive therapies (the control group),with risk ratios (RRs) of 2.71 (95% CI) 1.81 to 4.06)for tacrolimus+tripterygium wilfordii (TAC+TW), 2.16 (1.27 to 3.69) foradrenocorticotropic hormone, 2.02 (1.64 to 2.49) for TAC, 2.03 (1.13 to3.64) for azathioprine (AZA), 1.91 (1.46 to 2.50) for cyclosporine (CsA), 1.86 (1.44 to2.42) for mycophenolate mofetil (MMF), 1.85 (1.52 to 2.25) for cyclophosphamide (CTX),1.81 (1.10 to 2.98) for rituximab (RIT), 1.80 (1.38 to 2.33) for TW, 1.72 (1.35 to 2.19) for chlorambucil. As for 24 hours UTP, the direct andindirect comparisons showed that AZA (standard mean difference (SMD), \u22121.02(95% CI \u22121.90 to \u22120.15)), CsA (SMD, \u22120.70 (95% CI \u22121.33 to \u22120.08)),CTX (SMD, \u22121.01 (95% CI \u22121.44 to -0.58)), MMF (SMD, \u22120.98 (95% CI \u22121.64 to \u22120.32)), MZB (SMD, \u22120.97 (95% CI \u22121.90 to\u22120.04]), TAC (SMD, \u22121.16 (95% CI \u22121.72 to \u22120.60)) and TAC+TW(SMD, \u22122.03 (95% CI \u22122.94 to \u22121.12)) could significantly superior thancontrol, except for chlorambucil, LEF, RIT and STE. Thechanges of serum creatinine (Scr) was not significantly different between eachtreatments of immunosuppressive agents and the control, except for STE whichhas the possibility of increasing Scr (SMD, 1.00 (95% CI 0.36 to 1.64)).Comparisons among all treatments of immunosuppressive agents showed nostatistical significance in the outcome of relapse. A drenocorticotropichormone (85.1%) showed the lowest probability of relapse under the cumulativeranking curve values among all immunosuppressants. Infection,gastrointestinal symptoms, and bone marrow suppression were the common adverseevents associated with most of the immunosuppressive therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that TAC+TW, TAC and CTX are superior to other immunosuppressive agents in terms of TR and 24\u2009hours UTP. Moreover, they are all at risk of infection, gastrointestinal symptoms, and myelosuppression. Furthermore, TAC could increase the risk of glucose intolerance or new-onset diabetes mellitus. Conversely, STE alone, LEF and MZB seem to have little advantage in clinical treatment of IMN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42018094228.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-030919","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T08:55:24Z","timestamp":1568192124000},"page":"e030919","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Comparative efficacy of 13 immunosuppressive agents for idiopathic membranous nephropathy in adults with nephrotic syndrome: a systematic review and network meta-analysis"],"prefix":"10.1136","volume":"9","author":[{"given":"Qiyan","family":"Zheng","sequence":"first","affiliation":[{"name":"First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China"},{"name":"Department of nephrology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huisheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Acupuncture and Moxibustion, China Academy of Chinese Medicine Science, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of nephrology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"},{"name":"Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of nephrology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"},{"name":"Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Zhao","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China"},{"name":"Department of nephrology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Beijing University of Chinese Medicine, Beijing, China"},{"name":"Department of nephrology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanan","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of nephrology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luying","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of nephrology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"},{"name":"Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,11]]},"reference":[{"key":"2025121514460262000_9.9.e030919.1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfw404"},{"key":"2025121514460262000_9.9.e030919.2","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1002\/phar.1575","article-title":"Overview of current and alternative therapies for idiopathic membranous nephropathy","volume":"35","author":"Tran","year":"2015","journal-title":"Pharmacotherapy"},{"key":"2025121514460262000_9.9.e030919.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-017-0525-6","article-title":"Factors affecting the long-term outcomes of idiopathic membranous nephropathy","volume":"18","author":"Huh","year":"2017","journal-title":"BMC Nephrol"},{"key":"2025121514460262000_9.9.e030919.4","doi-asserted-by":"crossref","unstructured":"Chen Y , Schieppati A , Chen X , et al . 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Clinical observation of the tacrolimus therapy in 30 cases of membranous nephropathy. Zhengzhou University, 2013."},{"key":"2025121514460262000_9.9.e030919.65","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016040449"},{"key":"2025121514460262000_9.9.e030919.66","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/oxfordjournals.qjmed.a068422","article-title":"The medical Research Council trial of short-term high-dose alternate day prednisolone in idiopathic membranous nephropathy with nephrotic syndrome in adults","volume":"74","author":"Cameron","year":"1990","journal-title":"Q J Med"},{"key":"2025121514460262000_9.9.e030919.67","first-page":"115","article-title":"Clinical observation of 20 cases of membranous nephropathy treated with small dose cyclosporine","volume":"14","author":"Wu","year":"2011","journal-title":"China Pharmacist"},{"key":"2025121514460262000_9.9.e030919.68","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61566-9"},{"key":"2025121514460262000_9.9.e030919.69","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.autrev.2016.12.005","article-title":"Calcineurin inhibitors versus cyclophosphamide for idiopathic membranous nephropathy: a systematic review and meta-analysis of 21 clinical trials","volume":"16","author":"Qiu","year":"2017","journal-title":"Autoimmun Rev"},{"key":"2025121514460262000_9.9.e030919.70","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s11596-015-1480-8","article-title":"Efficacy and safety of tacrolimus vs. cyclophosphamide for idiopathic membranous nephropathy: a meta-analysis of Chinese adults","volume":"35","author":"Li","year":"2015","journal-title":"J Huazhong Univ Sci Technolog Med Sci"},{"key":"2025121514460262000_9.9.e030919.71","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s40265-016-0683-z","article-title":"Efficacy and safety of tacrolimus versus cyclophosphamide for primary membranous nephropathy: a meta-analysis","volume":"77","author":"Zhu","year":"2017","journal-title":"Drugs"},{"key":"2025121514460262000_9.9.e030919.72","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002628"},{"key":"2025121514460262000_9.9.e030919.73","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.41"},{"key":"2025121514460262000_9.9.e030919.74","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1186\/s12882-015-0199-x","article-title":"Comparison of Tripterygium wilfordii multiglycosides and tacrolimus in the treatment of idiopathic membranous nephropathy: a prospective cohort study","volume":"16","author":"Liu","year":"2015","journal-title":"BMC Nephrol"},{"key":"2025121514460262000_9.9.e030919.75","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0184398","article-title":"Comparative effectiveness and tolerance of immunosuppressive treatments for idiopathic membranous nephropathy: a network meta-analysis","volume":"12","author":"Ren","year":"2017","journal-title":"PLoS One"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-030919","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:46:14Z","timestamp":1765838774000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-030919"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":75,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,11]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bmjopen-2019-030919"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-030919","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}