Tacrolimus is an effective treatment for lupus nephritis in pregnancy.

Abstract:

:Lupus nephritis during pregnancy increases morbidity and mortality for mother and baby. Flares are difficult to treat as many therapeutic options are teratogenic or fetotoxic. Steroids alone may be unable to control disease activity and are associated with higher rates of preterm delivery, sepsis and gestational diabetes. Reports of using tacrolimus to treat lupus nephritis in pregnancy are limited. We describe the pregnancies of nine women in whom tacrolimus was successfully used to treat lupus nephritis flare (six patients) or maintain stable disease (three patients). Introduction or dose escalation of oral steroids was avoided in five of the patients who developed active disease and steroid dose was rapidly reduced in the sixth patient. All women with disease flare attained partial or complete remission after starting tacrolimus. None of the women on maintenance treatment developed active disease. We propose tacrolimus as an effective adjuvant or alternative therapy to steroids for treating lupus nephritis flare or maintaining stable disease during pregnancy.

journal_name

Lupus

journal_title

Lupus

authors

Webster P,Wardle A,Bramham K,Webster L,Nelson-Piercy C,Lightstone L

doi

10.1177/0961203314540353

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

1192-6

issue

11

eissn

0961-2033

issn

1477-0962

pii

0961203314540353

journal_volume

23

pub_type

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