Abstract
BackgroundHydroxychloroquine (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.MethodsThis 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.ResultsProteinuria 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.ConclusionsUse of HCQ achieved has similar reduction in proteinuria compared to conventional IS therapy in patients with IgAN who had insufficient responses to IS therapy.
Highlights
Hydroxychloroquine (HCQ) is a well-known immunomodulator that was recently used in immunoglobulin A (IgA) nephropathy (IgAN) due to its antiproteinuric effects
The STOPIgAN and TESTING studies showed that treatment with CS in Immunoglobulin A nephropathy (IgAN) led to a reduction in proteinuria, treatment with CS was associated with a significantly increased risk of serious adverse events (SAEs) [5]
Among the 26 patients treated with HCQ, 14 patients were initially treated with CS therapy plus IS agents before HCQ treatment, half of whom were treated with CS plus CTX, and the average cumulative dose of cyclophosphamide was greater than 7 g
Summary
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. 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 m2) after 3–6 months of optimized supportive care should receive a 6-month course of corticosteroid (CS) therapy [4]. The results were inconclusive [10]
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.
