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Adrenocorticotropic Hormone in the Treatment of Focal Segmental Glomerulosclerosis Following Kidney Transplantation.

Abstract
This retrospective study examined the effect of adrenocorticotropic hormone therapy on remission of recurrent focal segmental glomerulosclerosis (FSGS) in patients with history of kidney transplant (KT) treated at 2 transplant centers. Patients with biopsy-confirmed FSGS following KT who received Acthar Gel (Mallinckrodt ARD, Bedminster, New Jersey, United States) treatment for ≥1 month were eligible. A total of 14 patients with idiopathic FSGS were included. Acthar Gel treatment resulted in complete remission of FSGS in 3 patients and partial remission in 2 patients for a total treatment response rate of 36% (5/14) of patients. Among patients showing complete or partial remission, Acthar Gel treatment duration ranged from 6 months to 2 years and 60% (3/5 patients) had serum creatinine ≤ 2 mg/dL at the start of Acthar Gel treatment. Patient outcomes suggest Acthar Gel may be an effective and tolerable treatment for recurrent FSGS in patients with history of KT. Early initiation of Acthar Gel treatment and therapy duration of at least 6 months may be needed for optimal response to Acthar Gel in patients with history of KT and recurrent FSGS.
AuthorsMónica Grafals, Asif Sharfuddin
JournalTransplantation proceedings (Transplant Proc) 2019 Jul - Aug Vol. 51 Issue 6 Pg. 1831-1837 ISSN: 1873-2623 [Electronic] United States
PMID31399168 (Publication Type: Evaluation Study, Journal Article)
CopyrightCopyright © 2019 Elsevier Inc. All rights reserved.
Chemical References
  • Gels
  • Hormones
  • Adrenocorticotropic Hormone
  • Creatinine
Topics
  • Adrenocorticotropic Hormone (administration & dosage)
  • Adult
  • Biopsy
  • Creatinine (blood)
  • Female
  • Gels
  • Glomerulosclerosis, Focal Segmental (blood, drug therapy, etiology)
  • Hormones (administration & dosage)
  • Humans
  • Induction Chemotherapy
  • Kidney Transplantation (adverse effects)
  • Male
  • Middle Aged
  • Postoperative Complications (blood, drug therapy, etiology)
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

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