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
Lupusjournal_title
Lupusauthors
Webster P,Wardle A,Bramham K,Webster L,Nelson-Piercy C,Lightstone Ldoi
10.1177/0961203314540353subject
Has Abstractpub_date
2014-10-01 00:00:00pages
1192-6issue
11eissn
0961-2033issn
1477-0962pii
0961203314540353journal_volume
23pub_type
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