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Article Open Access

Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis

Corrigendum in: /10.3892/etm.2019.7267
  • Authors:
    • Yanli Liu
    • Jun Xiao
    • Xintian Shi
    • Guojun Hao
    • Qinkai Chen
    • Jing Zhou
    • Xin Wei
  • View Affiliations / Copyright

    Affiliations: Department of Nephrology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi 330006, P.R. China
    Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 49-56
    |
    Published online on: November 12, 2015
       https://doi.org/10.3892/etm.2015.2860
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Abstract

Immunoglobulin A nephropathy (IgAN) is one of the most common types of primary glomerular disease. Immunosuppressive treatment for patients with IgAN remains controversial. The present meta-analysis aimed to assess the efficacy and safety of various immunosuppressive agents compared with steroids in patients with IgAN and moderate to severe proteinuria. PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Database and Qinghuatongfang were searched for relevant randomized controlled trials (RCTs) published between 1990 and September 2013. All eligible studies (biopsy proven IgA nephropathy, use of immunosuppressive agents) measured urinary protein excretion and proteinuria remission. Data were analyzed with the random effects model using Review Manager. A total of 29 RCTs were included, involving 1,466 patients. Compared with steroids, immunosuppressive agents, including azathioprine (AZA) [complete response (CR)/partial response (PR); relative risk (RR), 3.43; 95% confidence interval (CI) 1.92–6.12; P<0.0001], mycophenolate mofetil (MMF) (CR/PR; RR, 2.19; 95% CI, 1.25–3.85; P=0.006) and leflunomide (LET) (CR/PR; RR, 2.64; 95% CI, 1.80–3.86; P<0.00001) resulted in increased partial or complete proteinuria remission. Cyclophosphamide (CTX) resulted in a higher reduction of urinary protein excretion than steroids (SMD, 0.91; 95% CI, 0.41–1.41; P=0.0004)). Compared to CTX, LET showed higher effectiveness (CR/PR; RR, 2.01; 95% CI, 1.08–3.75; P=0.03) with a lower incidence of adverse events. The present meta-analysis, which is based on IgAN patients, suggested that AZA, MMF, LET and CTX are effective in reducing proteinuria levels, with acceptable side effects. Therefore, immunosuppressive agents may be considered promising therapeutic agents for the treatment of IgAN and should be investigated further in large sample size, high-quality studies.
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1 

Berger J and Hinglais N: Intercapillary deposits of IgA-IgG. J Urol Nephrol (Paris). 74:694–695. 1968.(In French). PubMed/NCBI

2 

Bartosik LP, Lajoie G, Sugar L and Cattran DC: Predicting progression in IgA nephropathy. Am J Kidney Dis. 38:728–735. 2001. View Article : Google Scholar : PubMed/NCBI

3 

D Amico G: Natural history of idiopathic IgA nephropathy: Role of clinical and histological prognostic factors. Am J Kidney Dis. 36:227–237. 2000. View Article : Google Scholar : PubMed/NCBI

4 

Alamartine E, Sabatier JC, Guerin C, Berliet JM and Berthoux F: Prognostic factors in mesangial IgA glomerulonephritis: An extensive study with univariate and multivariate analyses. Am J Kidney Dis. 18:12–19. 1991. View Article : Google Scholar : PubMed/NCBI

5 

Bogenschütz O, Bohle A, Batz C, Wehrmann M, Pressler H, Kendziorra H and Gärtner HV: IgA nephritis: On the importance of morphological and clinical parameters in the long-term prognosis of 239 patients. Am J Nephrol. 10:137–147. 1990. View Article : Google Scholar : PubMed/NCBI

6 

Reich HN, Troyanov S, Scholey JW and Cattran DC: Toronto Glomerulonephritis Registry: Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 18:3177–3183. 2007. View Article : Google Scholar : PubMed/NCBI

7 

Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH, Somers MJ, Trachtman H and Waldman M: KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis. Am J Kidney Dis. 62:403–441. 2013. View Article : Google Scholar : PubMed/NCBI

8 

Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ and McQuay HJ: Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials. 17:1–12. 1996. View Article : Google Scholar : PubMed/NCBI

9 

Huang S: Clinical observation of Benazepril combined with azathioprine on IgA nephropathy. Guo Ji Yi Yao Wei Sheng. 20:53–55. 2009.

10 

Kuang B: Clinical observation of Benazepril combined with azathioprine on IgA nephropathy. ZhongGuo Xian Dai Yi Sheng. 19:6–7. 2010.

11 

Li YN: Curative effect analysis of Benazepril combined with azathioprine on IgA nephropathy along with the amount of proteinuria. Hua Bei Mei Tan Yi Xue Yuan XueBao. 4:471–472. 2011.

12 

Ma FL: Clinical research oil azathioprine combined with benazepril treating IgA nephropathy. Xian Dai Zhen Duan Yu Zhi Liao. 6:653–654. 2012.

13 

Xu H: Azathioprine and prednisone, valsartan Clinical observation on treatment of IgA nephropathy. Zhe Jiang Yi Xue. 3:227–229. 2013.

14 

Chen XM, Chen P, Cai G, Wu J, Cui Y, Zhang Y, Liu S and Tang L: A randomized control trial of mycophenolate mofeil treatment in severe IgA nephropathy. Zhonghua Yi Xue Za Zhi. 82:796–801. 2002.(In Chinese). PubMed/NCBI

15 

Chen XSh: Clinic Effect of Mycophenolate Mofetil combined Valsartan on IgA Nephropathy. Zhong Guo Yi Yao Zhi Nan. 20:53–54. 2010.

16 

Guo QY: Efficacy of pediatric IgA nephropathy mycophenolate mofetil combined hormone therapy. Guang Dong Yi Xue. 7:902–903. 2010.

17 

Huang Zh: Efficacy of focal proliferative sclerosing 38 cases of patients with IgA nephropathy. He Nan Yi Xue Yan Jiu. 4:437–439. 2012.

18 

Tang SC, Tang AW, Wong SS, Leung JC, Ho YW and Lai KN: Long-term study of mycophenolate mofetil treatment in IgA nephropathy. Kidney Int. 77:543–549. 2010. View Article : Google Scholar : PubMed/NCBI

19 

Wang WM: Clinical study on treatment of IgA nephropathy with renal insufficiency by corticosteroid, corticosteroid combined with cyclophosphamide and corticosteroid combined with mycophenolate mofetil. Shang Hai Jiao Tong Da Xue Xue Bao. 2:162–167, 173. 2013.

20 

Cao LO: Leflunomide in combination with medium/low dose of prednisolone in treatment of progressive IgA nephropathy. Shanghai Yi Xue. 9:791–795. 2009.

21 

Fu Q: Effects of leflunomide combined with hormone therapy for lg a nephropathy. Shan Xi Yi Xue Za Zhi. 3:351–353. 2009.

22 

Hu RH: IgA nephropathy leflunomide combined with hormone therapy. J Clinical Internal Medicine. 12:837–839. 2011.

23 

Huang YX: Leflunomide combined small dose glucocorticoid treatment of progressive IgA nephropathy Efficacy. Chinese Journal of Primary Medicine and Pharmacy. 18:1965–1966. 2011.

24 

Li T: Study on effect of leflunomide combined with glucocorticoid in treatment of progressive IgA nephropathy. Modern J Integrated Traditional Chinese and Western Medicine. 1:13–15. 2011.

25 

Lou TQ: Controlled trial of leflunomide in the treatment of immunoglobulin a nephropathy. Journal of Sun Yat-sem University (Medical Sciences). 5:570–572. 2005.

26 

Pu L: Efficacy of benazepril combined with leflunomide in treatment of IgA nephropathy. Jiangsu Medical Journal. 11:1277–1279. 2012.

27 

Shen P: Leflunomide combined with low-dose hormone therapy efficacy of IgA nephropathy. Chinese J General Practice. 10:1580–1581. 2012.

28 

Sun MD: Clinical observation of leflunomide treatment of IgA nephropathy. Chinese J Gerontology. 16:2038–2039. 2009.

29 

Wang L: Leflunomide combined with prednisone treatment of progressive IgA nephropathy Chronic. Suzhou University J Medical Science. 4:677–679. 2006.

30 

Yang FY: Controlled studies of leflunomide treatment of IgA nephropathy. China Practical Medical. 22:17–19. 2009.

31 

Zhang LW: Efficacy of leflunomide combined with hormone treatment of chronic progressive IgA nephropathy. Chinese Journal of Modern Drug Application. 20:116–118. 2010.

32 

Zhang Y: Efficacy of leflunomide combined with prednisone in the treatment of advanced IgA nephropathy. Academic J Guangzhou Medical College. 23:82–85. 2010.

33 

Liu Y: Accompanied by moderate proteinuria treatment of IgA nephropathy. China Medical Herald. 6:23–24. 2006.

34 

Guo M: Compare leflunomide or cyclophosphamide combined hormone therapy of chronic progressive IgA nephropathy. Guide of China Medicine. 28:142–143. 2012.

35 

Sun ZhX: Comparison of the efficacy of treatment with leflunomide and cyclophosphamide IgA nephropathy renal dysfunction. Suzhou University J Medical Science. 5:961–963. 2009.

36 

Zhang HF: Leflunomide combined with glucocorticoids contrast cyclophosphamide glucocorticoid treatment efficacy of IgA nephropathy. J Taishan Medical College. 6:434–436. 2013.

37 

Zhong ShH: Controlled studies of leflunomide and cyclophosphamide-based therapy to nephrotic syndrome of IgA nephropathy. J North China Coal Medical University. 5:593–594. 2011.

38 

Lv J, Xu D, Perkovic V, Ma X, Johnson DW, Woodward M, Levin A, Zhang H and Wang H; TESTING Study Group, : Corticosteroid therapy in IgA nephropathy. J Am Soc Nephrol. 23:1108–1116. 2012. View Article : Google Scholar : PubMed/NCBI

39 

Katafuchi R, Ninomiya T, Mizumasa T, Ikeda K, Kumagai H, Nagata M and Hirakata H: The improvement of renal survival with steroid pulse therapy in IgA nephropathy. Nephrol Dial Transplant. 23:3915–3920. 2008. View Article : Google Scholar : PubMed/NCBI

40 

Yoshikawa N, Honda M, Iijima K, Awazu M, Hattori S, Nakanishi K and Ito H; Japanese Pediatric IgA Nephropathy Treatment Study Group, : Steroid treatment for severe childhood IgA nephropathy: A randomized, controlled trial. Clin J Am Soc Nephrol. 1:511–517. 2006. View Article : Google Scholar : PubMed/NCBI

41 

Maes BD, Oyen R, Claes K, Evenepoel P, Kuypers D, Vanwalleghem J, Van Damme B and Vanrenterghem YF: Mycophenolate mofetil in IgA nephropathy: Results of a 3-year prospective placebo-controlled randomized study. Kidney Int. 65:1842–1849. 2004. View Article : Google Scholar : PubMed/NCBI

42 

Frisch G, Lin J, Rosenstock J, Markowitz G, D'Agati V, Radhakrishnan J, Preddie D, Crew J, Valeri A and Appel G: Mycophenolate mofetil (MMF) vs placebo in patients with moderately advanced IgA nephropathy: A double-blind randomized controlled trial. Nephrol Dial Transplant. 20:2139–2145. 2005. View Article : Google Scholar : PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Liu Y, Xiao J, Shi X, Hao G, Chen Q, Zhou J and Wei X: Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 . Exp Ther Med 11: 49-56, 2016.
APA
Liu, Y., Xiao, J., Shi, X., Hao, G., Chen, Q., Zhou, J., & Wei, X. (2016). Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 . Experimental and Therapeutic Medicine, 11, 49-56. https://doi.org/10.3892/etm.2015.2860
MLA
Liu, Y., Xiao, J., Shi, X., Hao, G., Chen, Q., Zhou, J., Wei, X."Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 ". Experimental and Therapeutic Medicine 11.1 (2016): 49-56.
Chicago
Liu, Y., Xiao, J., Shi, X., Hao, G., Chen, Q., Zhou, J., Wei, X."Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 ". Experimental and Therapeutic Medicine 11, no. 1 (2016): 49-56. https://doi.org/10.3892/etm.2015.2860
Copy and paste a formatted citation
x
Spandidos Publications style
Liu Y, Xiao J, Shi X, Hao G, Chen Q, Zhou J and Wei X: Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 . Exp Ther Med 11: 49-56, 2016.
APA
Liu, Y., Xiao, J., Shi, X., Hao, G., Chen, Q., Zhou, J., & Wei, X. (2016). Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 . Experimental and Therapeutic Medicine, 11, 49-56. https://doi.org/10.3892/etm.2015.2860
MLA
Liu, Y., Xiao, J., Shi, X., Hao, G., Chen, Q., Zhou, J., Wei, X."Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 ". Experimental and Therapeutic Medicine 11.1 (2016): 49-56.
Chicago
Liu, Y., Xiao, J., Shi, X., Hao, G., Chen, Q., Zhou, J., Wei, X."Immunosuppressive agents versus steroids in the treatment of IgA nephropathy-induced proteinuria: A meta-analysis Corrigendum in /10.3892/etm.2019.7267 ". Experimental and Therapeutic Medicine 11, no. 1 (2016): 49-56. https://doi.org/10.3892/etm.2015.2860
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