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Tytuł pozycji:

Efficacy of leflunomide combined with prednisone for the treatment of PLA2R-associated primary membranous nephropathy.

Tytuł:
Efficacy of leflunomide combined with prednisone for the treatment of PLA2R-associated primary membranous nephropathy.
Autorzy:
Guo Y; Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
Wu X; Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
Liu L; Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
Zhang H; Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
Yang L; Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
Chen W; Department of Nephrology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, People's Republic of China.
Źródło:
Renal failure [Ren Fail] 2020 Nov; Vol. 42 (1), pp. 122-130.
Typ publikacji:
Journal Article; Randomized Controlled Trial
Język:
English
Imprint Name(s):
Publication: London : Informa Healthcare
Original Publication: New York, N.Y. : M. Dekker, c1987-
MeSH Terms:
Glomerulonephritis, Membranous/*complications
Glomerulonephritis, Membranous/*drug therapy
Leflunomide/*therapeutic use
Nephrotic Syndrome/*complications
Prednisone/*therapeutic use
Adult ; Autoantibodies/blood ; Biomarkers/blood ; Cyclophosphamide/therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Leflunomide/adverse effects ; Male ; Middle Aged ; Prednisone/adverse effects ; Proteinuria/drug therapy ; Receptors, Phospholipase A2/immunology ; Remission Induction ; Serum Albumin
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Contributed Indexing:
Keywords: PLA2R; cyclophosphamide; leflunomide; prednisone; primary membranous nephropathy
Substance Nomenclature:
0 (Autoantibodies)
0 (Biomarkers)
0 (Immunosuppressive Agents)
0 (Receptors, Phospholipase A2)
0 (Serum Albumin)
8N3DW7272P (Cyclophosphamide)
G162GK9U4W (Leflunomide)
VB0R961HZT (Prednisone)
Entry Date(s):
Date Created: 20200121 Date Completed: 20201102 Latest Revision: 20201102
Update Code:
20240104
PubMed Central ID:
PMC7006764
DOI:
10.1080/0886022X.2020.1713806
PMID:
31957527
Czasopismo naukowe
Objective: To evaluate the clinical efficacy and safety of leflunomide (LEF) combined with prednisone for the treatment of PLA2R-associated primary membranous nephropathy (PMN) and changes in anti-PLA2R antibody titers after treatment. Methods: Sixty patients with nephrotic syndrome, biopsy-proven MN and anti-PLA2R antibody positivity were included in this study conducted from December 2017 to February 2019. The patients were randomly divided into an experimental group ( n  = 30) and a control group ( n  = 30). The patients in the experimental group were treated with LEF combined with prednisone, whereas the patients in the control group were treated with cyclophosphamide (CTX) combined with prednisone. We assessed 24-h urinary protein and serum albumin levels, kidney function markers, blood lipid levels and anti-PLA2R antibody titers before and after treatment. Adverse reactions during treatment were recorded. Results: After 16 weeks of treatment, there were 2 cases of complete remission and 6 cases of partial remission in the experimental group, with a total effective rate of 26.67%. In the control group, there were 4 cases of complete remission and 8 cases of partial remission, with a total effective rate of 40% ( p  > .05). After 24 weeks of treatment, the total effective rates of the experimental and control groups were 66.67% and 76.67%, respectively ( p >  .05). There were no significant differences in 24-h urinary protein, serum albumin, kidney function marker or blood lipid levels between the two groups after treatment ( p  > .05). However, there were fewer adverse reactions in the experimental group than in the control group ( p  < .05). After treatment, serum anti-PLA2R antibody titers were clearly decreased in patients with complete remission and partial remission ( p  < .05), but these levels remained relatively high in patients without remission ( p >  .05). Conclusion: LEF combined with prednisone has a certain efficacy for the treatment of PLA2R-associated PMN and provokes few adverse reactions. A large-sample randomized double-blind controlled study with a long follow-up period is needed to verify the efficacy of LEF combined with prednisone.
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