Acth or Adrenocortical Steroid Therapy of Proteinuria in Adolescents and in Adults

Ts, Danowski; Fm, Mateer; Aj, Puntereri

doi:10.1097/00000441-195905000-00001

Cited by 18 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Long-term ACTH treatment results are summarized in Table 2 [ 13 , 17 , 38 – 40 ]. All regimens included an initial short-term daily ACTH treatment course.…”

Section: Resultsmentioning

confidence: 99%

“…The regimens of four studies included intermittent ACTH treatment for three consecutive days repeated weekly for up to 24 months. One study used long-term daily ACTH treatment for up to 19 months as maintenance therapy [ 38 ]. In the remaining study, the initial ACTH treatment course was followed by daily ACTH treatment at 1 mg/lb/day until absence of albuminuria for 1–2 weeks [ 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Sustained proteinuria response was examined in the five long-term studies. Evaluation of proteinuria response during long-term ACTH or combined long-term ACTH and post-treatment follow-up showed proteinuria response in 71 % (63/89) of patients [ 13 , 17 , 38 , 40 ]. The two studies that reported proteinuria response post-treatment showed 61 % (19/31) of patients had sustained proteinuria response for up to 26 months [ 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patient follow-up ranged from 1 month to 4.7 years [ 13 , 17 , 38 – 40 ]. In a study of 25 patients, sustained proteinuria response following ACTH cessation was shown in 14 patients for a mean of 9.6 months and another nine patients showed continued proteinuria response during their ongoing ACTH intermittent regimen [ 40 ].…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Adrenocorticotropic hormone therapy for the treatment of idiopathic nephrotic syndrome in children and young adults: a systematic review of early clinical studies with contemporary relevance

Lieberman

Pavlova-Wolf

2016

J Nephrol

View full text Add to dashboard Cite

Adrenocorticotropic hormone (ACTH) as a treatment for proteinuria due to nephrotic syndrome (NS) has re-emerged over the last decade. Current clinical data are primarily limited to adults with treatment-resistant NS. Largely unknown to today’s clinicians is the existence of early clinical studies, following ACTH’s introduction in the late 1940s, showing sustained proteinuria response in idiopathic NS in predominantly pediatric, treatment-naïve patients. Before ACTH, patients suffered severe edema and high mortality rates with no reliable or safe treatment. ACTH dramatically altered NS management, initially through recognition of diuresis effects and then through sustained proteinuria remission. This review synthesizes early clinical literature to inform current NS patient management. We undertook a MEDLINE search using MeSH terms “adrenocorticotropic hormone” and “nephrotic syndrome,” with limits 1945–1965 and English. Sixty papers totaling 1137 patients were found; 14 studies (9 short-term, five long-term, N = 419 patients) met inclusion criteria. Studies were divided into two groups: short-term (≤28 days) and long-term (>5 weeks; short-term initial daily treatment followed by long-term intermittent)ACTH therapy and results were aggregated. An initial response, defined as a diuresis, occurred in 74 % of patients/treatment courses across nine short-term ACTH studies. Analyzed in eight of these studies, proteinuria response occurred in 56 % of patients/treatment courses. Across five long-term ACTH studies, proteinuria response was shown in 71 % of patients and was sustained up to 4.7 years following treatment. The inventory and re-evaluation of early clinical data broadens the evidence base of clinical experiences with ACTH for implementation of current treatment strategies and aiding the design of future studies.Electronic supplementary materialThe online version of this article (doi:10.1007/s40620-016-0308-3) contains supplementary material, which is available to authorized users.

show abstract

“…Long-term ACTH treatment results are summarized in Table 2 [ 13 , 17 , 38 – 40 ]. All regimens included an initial short-term daily ACTH treatment course.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Adrenocorticotropic hormone therapy for the treatment of idiopathic nephrotic syndrome in children and young adults: a systematic review of early clinical studies with contemporary relevance

Lieberman

Pavlova-Wolf

2016

J Nephrol

View full text Add to dashboard Cite

show abstract

“…Among many reports of their use in a variety of kidney diseases there were scattered experiences with diabetic glomerulosderosis. The report of Danowski and others [30] was typical: three advanced cases were treated with ACTH or cortisone for one to three months. Judgement of benefit was based entirely on clinical response, and this was poor.…”

Section: Prevention or Reversal Of Diabetic Kidney Diseasementioning

confidence: 93%