Study conducted in several countries reveals a clear treatment option with defined benefits that outweigh the risks.
IgA nephropathy, is the autoimmune condition, where the body generate antibodies to fight infections that form deposits in the kidneys. Photo: Shutterstock.
It was found that by treatment con methylprednisolone the risk of losing function or having kidney failure can be reduced by half, by implementing a reduced dose, which effectively reduces side effects; thanks to the largest randomized controlled trial performed on the nephropathy by immunoglobulin A (IgA).
Known as IgA nephropathy, it is the autoimmune condition, where the body generates antibodies to fight infections that form deposits in the kidneyswhich as a consequence produces inflammation and scarring, which if it progresses might cause kidney failure in a percentage of the population.
Vlado Perkovicprincipal investigator of the University of New South Wales (Australia), notes that between 10 and 30 percent of people with this disease develop kidney failure that requires dialysis or a kidney transplant.
“We found that treatment with methylprednisolone for 6 to 9 months significantly reduced the risk of losing substantial kidney function, developing kidney failure requiring dialysis or transplantation, or dying from kidney disease, compared to placebo,” Vlado Perkovic.
The study Therapeutic Evaluation of Steroids in IgA Nephropathy Global (TESTING) is a double-blind, randomized, controlled trial involving 67 centers in 6 countries and evaluating the effects of oral methylprednisolone on the main renal outcomes, renal insufficiency and safety in patients with nephropathy IgA.
“There are few proven treatment options, so many treatments, including corticosteroids, have been used in some patients for decades, despite uncertainty regarding their efficacy, as well as the ideal dose,” Perkovic said. what opens room for significant variability in terms of uncertainty regarding this type of treatment.
503 patients diagnosed with IgA nephropathy in centers from Australia, Canada, China (included Hong Kong), India y Malaysia between May 2012 and November 2019. They were randomly assigned to one of two groups treated with methylprednisolone or placebo.
“However, there was a increase in adverse events severe among those receiving methylprednisolone, primarily seen in the full-dose regimen, but less so in the reduced-dose treatment group.
The joint principal investigator, Hong Zhangfrom Peking University (China), adds that, being nephropathy due to IgA an immune-mediated disease, the benefits observed were probably due to the immunosuppressive action of corticosteroid treatment.
Vlado says, “A well-known side effect of corticosteroid treatment is an increased risk of infection, but we found that this might be mitigated to some extent by using the lowest dose and giving patients antibiotics to prevent infection, this is the strongest evidence to date of the benefit of any treatment for the prevention of kidney failure in people with IgA nephropathy.
It concludes, setting the precedent, that “the results provide a treatment option for clinicians and patients, especially at the lower dose, given the net benefits versus the risk of side effects.”
consulted source here.
