Corticosteroids in the treatment of IgA nephropathy: any light beyond the clouds of confusion?

Chan, Tak Mao

doi:10.1136/postgradmedj-2017-135239

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…Therefore, no specific therapies targeting the key pathways involved in its pathogenesis are available [ 2 ]. Under these circumstances, blood pressure optimization and renin-angiotensin-aldosterone system inhibitors (RAASis) are the primary management methods [ 3 ]. The 2012 Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for glomerulonephritis suggest that patients with persistent proteinuria (≥1 g/d and an estimated glomerular filtration rate [eGFR] > 50 ml/min per 1.73 m 2 ) after 3–6 months of optimized supportive care should receive a 6-month course of corticosteroid (CS) therapy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of hydroxychloroquine in patients with IgA nephropathy with insufficient responses to immunosuppressive therapy: a retrospective case-control study

Tang

Shi

et al. 2020

BMC Nephrol

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Background Hydroxychloroquine (HCQ) is a well-known immunomodulator that was recently used in immunoglobulin A (IgA) nephropathy (IgAN) due to its antiproteinuric effects. We investigated the effects of HCQ in patients with IgAN whose proteinuria remained above 1 g/d after conventional immunosuppressive (IS) therapy. Methods This study was a retrospective case-control study. Twenty-six patients with IgAN who received HCQ and had insufficient responses to IS therapy (corticosteroid (CS) therapy with/without IS agents) were included. Twenty-six matched historical controls who received conventional IS therapy were selected using propensity score matching. The clinical data from 6 months were compared. Results Proteinuria at baseline was comparable between the “IS therapy plus HCQ” and “conventional IS therapy” groups (2.35 [interquartile range (IQR), 1.47, 2.98] vs. 2.35 [IQR, 1.54, 2.98] g/d, p = 0.920). A significant reduction in proteinuria was noted in IgAN patients with HCQ treatment (2.35 [IQR, 1.47, 2.98] vs. 1.10 [IQR, 0.85, 1.61] g/d, p = 0.002). The percent reduction in proteinuria at 6 months was similar between the two groups (− 39.81% [− 66.26, − 12.37] vs. -31.99% [− 67.08, − 9.14], p = 0.968). The cumulative frequency of patients with a 50% reduction in proteinuria during the study was also comparable between the two groups (53.8% vs. 57.7%, p = 0.780). No serious adverse events (SAEs) were observed during the study. Conclusions Use of HCQ achieved has similar reduction in proteinuria compared to conventional IS therapy in patients with IgAN who had insufficient responses to IS therapy.

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Section: Introductionmentioning

confidence: 99%