Abstract
BackgroundThe results of leflunomide (LEF) in patients with IgA nephropathy (IgAN) were inconsistent.MethodsA total of 149 kidney biopsy-confirmed IgAN patients with an estimated glomerular filtration rate (eGFR) ≥ 50 ml/min/1.73 m2 and protein excretion levels ≥0.75 g/d were enrolled, with 65 subjects receiving half-dose CS plus LEF (LEF group), and the 84 counterpart patients accepting full-dose corticosteroid (Full CS group). The primary outcomes included the complete remission (CR) rates and incidence of adverse events (AEs). The secondary outcomes were the overall remission (OR) rates and a combined event (eGFR reduced ≥30%, end-stage renal disease [ESRD], hemodialysis, peritoneal dialysis or kidney transplantation).ResultsDuring the 18 months of follow-up, the CR rates were 72 and 64% in the LEF and Full CS groups (P = 0.299), respectively. The proportion of patients with OR rates in the LEF group and Full CS group was 89% versus 75%, respectively (P = 0.027). Serious AEs were observed only in the Full CS group (P = 0.017). The incidences of total AEs (P = 0.036) and infections (P = 0.024) were lower in the LEF group than in the Full CS group.ConclusionsLEF combined with half-dose CS is superior to full-dose CS in the treatment of IgAN.
Highlights
Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide [1]
The updated Kidney Disease Improving Global Outcomes (KDIGO) guidelines suggest that IgA nephropathy (IgAN) patients who remain at high risk of progressive chronic kidney disease (CKD) despite maximal supportive care are considered systemic glucocorticoids therapy for 6
Our previous research supported that half-dose CS plus renin-angiotensin system blockers (RASB) versus full-dose CS did not differ in terms of reducing proteinuria, but therapy with Half CS plus RASB resulted in fewer adverse events (AEs) in IgAN patients and might be a better option for IgAN [13]
Summary
Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide [1]. The updated Kidney Disease Improving Global Outcomes (KDIGO) guidelines suggest that IgAN patients who remain at high risk of progressive chronic kidney disease (CKD) despite maximal supportive care are considered systemic glucocorticoids therapy for 6. Several randomized trials demonstrated that LEF combined with low-dose CS is at least as effective as CS alone for the treatment of progressive IgA nephropathy, with fewer side effects [11, 12]. Our previous research supported that half-dose CS plus renin-angiotensin system blockers (RASB) versus full-dose CS did not differ in terms of reducing proteinuria, but therapy with Half CS plus RASB resulted in fewer AEs in IgAN patients and might be a better option for IgAN [13]. The results of leflunomide (LEF) in patients with IgA nephropathy (IgAN) were inconsistent
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
