In a 24-week study of adults with biopsy-proven lupus nephritis, multitarget therapy with tacrolimus (4 mg/day) and mycophenolate mofetil (1 g/day) was more efficacious than intravenous cyclophosphamide (starting dose 0.75 and adjusted to 0.5–1.0 g/m2 body surface area every 4 weeks) as an induction therapy. All patients were also given 3 days of pulse methylprednisolone and a tapering course of oral prednisone therapy. 45.9% of the multitarget group versus 25.6% of the cyclophosphamide group achieved complete remission (95% CI 10.0–30.6, P <0.001). Remission was achieved more quickly in the multitarget group compared with the cyclophosphamide group (mean difference −4.1; 95% CI −7.9 to −2.1 weeks). The incidence of adverse events were similar in the multitarget and intravenous cyclophophomide groups (50.3% [91 of 181] versus 52.5%, [95 of 181] respectively).