Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis

Yuyao Peng, Fei Jiang, Ran Zhou, Wanlin Jin, Yi Li, Weiwei Duan, Liqun Xu, Huan Yang Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of ChinaCorrespondence: Liqun Xu; Huan YangDepartment of Neurology, Xiangya Hospital, Central South University...

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Autores principales:	Peng Y, Jiang F, Zhou R, Jin W, Li Y, Duan W, Xu L, Yang H
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	myasthenia gravis tacrolimus wuzhi capsule clinical efficacy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/0d3da9fffe3e45d39b7fb251a3ff9775
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spelling	oai:doaj.org-article:0d3da9fffe3e45d39b7fb251a3ff97752021-12-02T18:31:00ZClinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis1178-2021https://doaj.org/article/0d3da9fffe3e45d39b7fb251a3ff97752021-07-01T00:00:00Zhttps://www.dovepress.com/clinical-evaluation-of-the-efficacy-and-safety-of-co-administration-of-peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Yuyao Peng, Fei Jiang, Ran Zhou, Wanlin Jin, Yi Li, Weiwei Duan, Liqun Xu, Huan Yang Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of ChinaCorrespondence: Liqun Xu; Huan YangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of ChinaTel +86 731-8432-7236Fax +86 731-8432-7401Email lilyxu1983@126.com; 403850@csu.edu.cnBackground: Tacrolimus has been recommended as an effective immunosuppressant for patients with myasthenia gravis (MG), while the high price, variable bioavailability, and narrow therapeutic window restrict its clinical application. Wuzhi capsule (WZC) could improve tacrolimus blood concentration by inhibiting the metabolism of cytochrome P450 3A (CYP3A) and P-glycoprotein (P-gp). There are few studies focused on the coadministration of WZC and tacrolimus in autoimmune diseases. This study was aimed at quantifying the efficacy and safety of coadministration of WZC and tacrolimus in adult Chinese patients with MG.Methods: In this retrospective study, 122 patients with MG on tacrolimus were enrolled. The initial tacrolimus dose was 2 mg/d. Patients with standard initial tacrolimus concentration were classified into group A (standard-dose group). Those failed to reach target concentration were divided into group B (high-dose group) and group C (co-administering WZC group), according to treatment adjustment of increasing tacrolimus dose and co-administration of WZC, respectively. A logistic analysis was used to identify factors associated with clinical outcome. Adverse drug reactions (ADRs) were recorded for safety analysis.Results: The tacrolimus concentration after coadministration of WZC was remarkably increased. It was higher compared with simply increasing the tacrolimus dose (p< 0.001). The multivariate logistic analysis indicated that the baseline quantitative MG score was a predictive factor for clinical outcomes (OR=0.189; 95% CI 0.082– 0.436; p< 0.001). Fourteen patients (11.5%) reported ADRs after tacrolimus therapy. ADRs incidence was not related to WZC coadministration.Conclusion: The coadministration of WZC and tacrolimus can substantially elevate the tacrolimus concentration. It is a safe and economic treatment for adult Chinese patients with MG. Patients with a worse disease condition tend to present a better clinical outcome after tacrolimus therapy.Keywords: myasthenia gravis, tacrolimus, Wuzhi capsule, clinical efficacyPeng YJiang FZhou RJin WLi YDuan WXu LYang HDove Medical Pressarticlemyasthenia gravistacrolimuswuzhi capsuleclinical efficacyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 2281-2289 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	myasthenia gravis tacrolimus wuzhi capsule clinical efficacy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	myasthenia gravis tacrolimus wuzhi capsule clinical efficacy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Peng Y Jiang F Zhou R Jin W Li Y Duan W Xu L Yang H Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis
description	Yuyao Peng, Fei Jiang, Ran Zhou, Wanlin Jin, Yi Li, Weiwei Duan, Liqun Xu, Huan Yang Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of ChinaCorrespondence: Liqun Xu; Huan YangDepartment of Neurology, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of ChinaTel +86 731-8432-7236Fax +86 731-8432-7401Email lilyxu1983@126.com; 403850@csu.edu.cnBackground: Tacrolimus has been recommended as an effective immunosuppressant for patients with myasthenia gravis (MG), while the high price, variable bioavailability, and narrow therapeutic window restrict its clinical application. Wuzhi capsule (WZC) could improve tacrolimus blood concentration by inhibiting the metabolism of cytochrome P450 3A (CYP3A) and P-glycoprotein (P-gp). There are few studies focused on the coadministration of WZC and tacrolimus in autoimmune diseases. This study was aimed at quantifying the efficacy and safety of coadministration of WZC and tacrolimus in adult Chinese patients with MG.Methods: In this retrospective study, 122 patients with MG on tacrolimus were enrolled. The initial tacrolimus dose was 2 mg/d. Patients with standard initial tacrolimus concentration were classified into group A (standard-dose group). Those failed to reach target concentration were divided into group B (high-dose group) and group C (co-administering WZC group), according to treatment adjustment of increasing tacrolimus dose and co-administration of WZC, respectively. A logistic analysis was used to identify factors associated with clinical outcome. Adverse drug reactions (ADRs) were recorded for safety analysis.Results: The tacrolimus concentration after coadministration of WZC was remarkably increased. It was higher compared with simply increasing the tacrolimus dose (p< 0.001). The multivariate logistic analysis indicated that the baseline quantitative MG score was a predictive factor for clinical outcomes (OR=0.189; 95% CI 0.082– 0.436; p< 0.001). Fourteen patients (11.5%) reported ADRs after tacrolimus therapy. ADRs incidence was not related to WZC coadministration.Conclusion: The coadministration of WZC and tacrolimus can substantially elevate the tacrolimus concentration. It is a safe and economic treatment for adult Chinese patients with MG. Patients with a worse disease condition tend to present a better clinical outcome after tacrolimus therapy.Keywords: myasthenia gravis, tacrolimus, Wuzhi capsule, clinical efficacy
format	article
author	Peng Y Jiang F Zhou R Jin W Li Y Duan W Xu L Yang H
author_facet	Peng Y Jiang F Zhou R Jin W Li Y Duan W Xu L Yang H
author_sort	Peng Y
title	Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis
title_short	Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis
title_full	Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis
title_fullStr	Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis
title_full_unstemmed	Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis
title_sort	clinical evaluation of the efficacy and safety of co-administration of wuzhi capsule and tacrolimus in adult chinese patients with myasthenia gravis
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/0d3da9fffe3e45d39b7fb251a3ff9775
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Clinical Evaluation of the Efficacy and Safety of Co-Administration of Wuzhi Capsule and Tacrolimus in Adult Chinese Patients with Myasthenia Gravis

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