{
  "abstract": "This study was designed to evaluate the efficacy of moderate-dose glucocorticoid (mGC) combined with tacrolimus (FK506) in high-risk patients with membranous nephropathy (MN), and compare with two widely used therapies: full-dose glucocorticoid (GC) plus cyclophosphamide (CTX), and rituximab (RTX) plus FK506, the latter being recommended by the Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines. This study aims to provide evidence for individualized treatment in high-risk MN. A total of 154 patients with high-risk MN were enrolled and assigned into three treatment groups: full-dose GC combined with CTX group (GC+CTX) (n=53), mGC combined with FK506 group (mGC+FK506) (n=51), and RTX combined with FK506 group (RTX+FK506) (n=50). Baseline clinical and laboratory parameters and follow-up data at 1, 3, 6, and 12 months post-treatment were collected. Outcomes including disease remission rates, relapse rates, and adverse events were compared among the three groups. At 12 months of follow-up, the overall remission rates for the GC+CTX, mGC+FK506, and RTX+FK506 groups were 94.4%, 94.1%, and 82.0%, respectively, with corresponding complete remission rates of 32.1%, 43.1%, and 24.0%. No significant intergroup differences were observed (P > 0.05). The mGC+FK506 group demonstrated higher remission rates at both 3 and 6 months. Multivariate Cox regression indicated that baseline serum albumin > 20 g/L was a protective factor (HR = 1.638, P = 0.004), and comorbid diabetes mellitus an independent risk factor (HR = 0.617, P = 0.032). The mGC+FK506 regimen was non-inferior to the GC+CTX and RTX+FK506 regimens in treating high-risk MN, with an earlier onset of therapeutic effect and superior remission rates at 3 and 6 months. Early correction of hypoalbuminemia and strict glycemic control are critical for improving prognosis. This study may provide evidence for individualized treatment selection in high-risk MN patients who are intolerant to high-dose GC or have limited access to RTX.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nephrology, the First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.",
    "Department of Integrated Traditional Chinese and Western Medicine, Liaoning University of Traditional Chinese Medicine Xinglin College, Shenyang, Liaoning, People's Republic of China.",
    "Laboratory of Epigenetics, School of Life Sciences, China Medical University, Shenyang, Liaoning, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lu Sui",
      "orcid": "0009-0002-1707-2302"
    },
    {
      "affs": [
        0
      ],
      "name": "Yutong Ma"
    },
    {
      "affs": [
        1
      ],
      "name": "Xintian Yu",
      "orcid": "0009-0007-1221-6617"
    },
    {
      "affs": [
        0
      ],
      "name": "Yilin Meng",
      "orcid": "0009-0003-9468-3956"
    },
    {
      "affs": [
        0
      ],
      "name": "Xuqi Cui",
      "orcid": "0009-0003-1475-5156"
    },
    {
      "affs": [
        0
      ],
      "name": "Hao Geng",
      "orcid": "0009-0007-9831-3046"
    },
    {
      "affs": [
        0
      ],
      "name": "Jian Zhang",
      "orcid": "0009-0002-6663-608X"
    },
    {
      "affs": [
        2
      ],
      "name": "Xiao Bai"
    },
    {
      "affs": [
        2
      ],
      "name": "Weihao Shang"
    },
    {
      "affs": [
        0
      ],
      "name": "Li Sun",
      "orcid": "0000-0002-9682-990X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8ve7vtr1kxh5t.bib",
  "cited_by": 0,
  "doi": "10.2147/dddt.s639867",
  "fulltext_url": "https://europepmc.org/articles/PMC13715842",
  "id": "8ve7vtr1kxh5t",
  "issns": [
    "1177-8881"
  ],
  "landing_url": "https://europepmc.org/article/MED/42953776",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2727|Renal Diseases and Glomerulopathies"
    ]
  ],
  "openalex": "W7223463013",
  "pdf_url": "https://europepmc.org/articles/PMC13715842?pdf=render",
  "pmcid": "PMC13715842",
  "pmid": "42953776",
  "published": "2026-10-24",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/8ve7vtr1kxh5t.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:40Z",
      "native_id": "MED:42953776",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42953776"
    },
    {
      "first_seen": "2026-11-01T12:23:02Z",
      "native_id": "PMC13715842",
      "source": "pmc",
      "url": "https://doi.org/10.2147/dddt.s639867"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Renal Diseases and Glomerulopathies",
      "subfield": "general"
    }
  ],
  "title": "Efficacy and Safety of Moderate-Dose Glucocorticoids with Tacrolimus in High-Risk Membranous Nephropathy: A Real-World Comparison of Three Immunosuppressive Regimens.",
  "title_text": "Efficacy and Safety of Moderate-Dose Glucocorticoids with Tacrolimus in High-Risk Membranous Nephropathy: A Real-World Comparison of Three Immunosuppressive Regimens.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:23:02Z",
  "url": "https://research.draconitic.com/paper/8ve7vtr1kxh5t",
  "venue": "Drug design, development and therapy",
  "versions": []
}