Background
Tacrolimus, a potent immunosuppressant and crucial calcineurin inhibitor, plays a central role in immunosuppression therapy post solid organ transplantation, particularly for kidney and liver transplants. Patients receiving tacrolimus are advised to undergo therapeutic drug monitoring.
Underexposure to tacrolimus can result in poor efficacy, whereas overexposure can cause nephrotoxicity and neurotoxicity via tacrolimus toxic reaction. Therefore, it is critical to maintain the whole-blood tacrolimus concentration levels within the target therapeutic concentration range. however, the drug is expensive, imposing a heavy financial burden on patients and health care insurance systems across China. Therefore, there is an urgent need for a cost-effective approach to reduce the tacrolimus dosage while preserving the drug’s therapeutic efficacy.
Wuzhi Capsule(WZC)is a traditional Chinese medicinal herb widely used to treat drug-induced hepatitis or liverdysfunction and is usually prescribed in China to increase tacrolimus concentration. This study aimed to evaluate the effect of WZC on whole blood tacrolimus concentration levels and safety.
Methods
We searched 7 databases for randomized clinical trials (RCTs) and observational studies (OSs) comparing whole-blood tacrolimus concentration levels between WZC and non-WZC treatments. Data analysis was performed using Review Manager version 5.3. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines.
Results
Conclusions
WZC is a safe and effective adjuvant drug that can increase whole-blood tacrolimus concentration levels and simultaneously protect liver function. It is an economical and practical treatment option for patients, especially those with poor oral tacrolimus absorption capabilities. Nevertheless, RCTs and OSs with large sample sizes and high quality are needed in the future to confirm these positive results.
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