Two-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide
<h4>Introduction</h4> <p>Both cCTX/GCs and CNIs are recommended as first-line agents in the management of PMN. The present study is an extended report of patients randomized to receive TAC/GCs or cCTX/GCs at 2 years post randomization.</p> <h4>Methods</h4> <p&...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2017
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| _version_ | 1826280097161674752 |
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| author | Ramachandran, R Yadav, A Kumar, V Siva Tez Pinnamaneni, V Nada, R Ghosh, R Kumar, V Rathi, M Kohli, H Gupta, K Sakhuja, V Jha, V |
| author_facet | Ramachandran, R Yadav, A Kumar, V Siva Tez Pinnamaneni, V Nada, R Ghosh, R Kumar, V Rathi, M Kohli, H Gupta, K Sakhuja, V Jha, V |
| author_sort | Ramachandran, R |
| collection | OXFORD |
| description | <h4>Introduction</h4> <p>Both cCTX/GCs and CNIs are recommended as first-line agents in the management of PMN. The present study is an extended report of patients randomized to receive TAC/GCs or cCTX/GCs at 2 years post randomization.</p> <h4>Methods</h4> <p>Seventy patients enrolled in the clinical trial Tacrolimus Combined With Corticosteroids Versus Modified Ponticelli Regimen in Treatment of Idiopathic Membranous Nephropathy: Randomized Control Trial were followed quarterly between 12 and 24 months. At the end of 24 months, 3 patients were lost to follow-up.</p> <h4>Results</h4> <p>At 18 months, 66% and 89% (P = 0.04) were in remission in TAC/GCs and cCTX/GCs groups, respectively. At 18 and 24 months, 60% and 86% (P ¼ 0.03) of cases were in remission in the TAC/GCs and cCTX/GCs groups, respectively. At 18 months, 57% and 83% (P = 0.03) of the patients in TAC/GCs and cCTX/GCs groups were in remission without need of any additional immunosuppression (persistent remission) and, at 24 months, 43% and 80% (P = 0.002) were in persistent remission in TAC/GCs and cCTX/GCs groups, respectively. Relapse rate after any remission was 40% and 6.7% in TAC/GCs and cCTX/GCs groups, respectively (P = 0.007). There was an association of aPLA2R titers with remission or resistance (P = 0.006) in relapsing PMN. The significant decrease in eGFR after 12 months of TAC/GCs therapy normalized at 18 and 24 months.</p> <h4>Discussion</h4> <p>At 2 years after randomization, relapse rates are higher for TAC/GCs compared with cCTX/GCs in PMN patients. Thus, cCTX/GCs are better than TAC/GCs in the longer term in PMN patients.</p> |
| first_indexed | 2024-03-07T00:08:36Z |
| format | Journal article |
| id | oxford-uuid:786bd7e3-7416-44a7-a7f7-c51b2e4e6c30 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:08:36Z |
| publishDate | 2017 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:786bd7e3-7416-44a7-a7f7-c51b2e4e6c302022-03-26T20:30:39ZTwo-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamideJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:786bd7e3-7416-44a7-a7f7-c51b2e4e6c30EnglishSymplectic Elements at OxfordElsevier2017Ramachandran, RYadav, AKumar, VSiva Tez Pinnamaneni, VNada, RGhosh, RKumar, VRathi, MKohli, HGupta, KSakhuja, VJha, V <h4>Introduction</h4> <p>Both cCTX/GCs and CNIs are recommended as first-line agents in the management of PMN. The present study is an extended report of patients randomized to receive TAC/GCs or cCTX/GCs at 2 years post randomization.</p> <h4>Methods</h4> <p>Seventy patients enrolled in the clinical trial Tacrolimus Combined With Corticosteroids Versus Modified Ponticelli Regimen in Treatment of Idiopathic Membranous Nephropathy: Randomized Control Trial were followed quarterly between 12 and 24 months. At the end of 24 months, 3 patients were lost to follow-up.</p> <h4>Results</h4> <p>At 18 months, 66% and 89% (P = 0.04) were in remission in TAC/GCs and cCTX/GCs groups, respectively. At 18 and 24 months, 60% and 86% (P ¼ 0.03) of cases were in remission in the TAC/GCs and cCTX/GCs groups, respectively. At 18 months, 57% and 83% (P = 0.03) of the patients in TAC/GCs and cCTX/GCs groups were in remission without need of any additional immunosuppression (persistent remission) and, at 24 months, 43% and 80% (P = 0.002) were in persistent remission in TAC/GCs and cCTX/GCs groups, respectively. Relapse rate after any remission was 40% and 6.7% in TAC/GCs and cCTX/GCs groups, respectively (P = 0.007). There was an association of aPLA2R titers with remission or resistance (P = 0.006) in relapsing PMN. The significant decrease in eGFR after 12 months of TAC/GCs therapy normalized at 18 and 24 months.</p> <h4>Discussion</h4> <p>At 2 years after randomization, relapse rates are higher for TAC/GCs compared with cCTX/GCs in PMN patients. Thus, cCTX/GCs are better than TAC/GCs in the longer term in PMN patients.</p> |
| spellingShingle | Ramachandran, R Yadav, A Kumar, V Siva Tez Pinnamaneni, V Nada, R Ghosh, R Kumar, V Rathi, M Kohli, H Gupta, K Sakhuja, V Jha, V Two-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide |
| title | Two-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide |
| title_full | Two-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide |
| title_fullStr | Two-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide |
| title_full_unstemmed | Two-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide |
| title_short | Two-year follow-up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide |
| title_sort | two year follow up study of membranous nephropathy treated with tacrolimus and corticosteroids versus cyclical corticosteroids and cyclophosphamide |
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