Potential benefits and related treatment effects of calcineurin inhibitors combined with steroid for IgA nephropathy: a systematic review and meta-analysis.

Abstract

BACKGROUND:

IgA nephropathy is not uncommon for clinical practice. Within multiple options of treatment, it is alternatively to consider less well-studied immunosuppressants such as calcineurin inhibitors (CNI). The knowledge of CNI with steroid in the treatment of IgA nephropathy can be clarified via a systematic review and meta-analysis of randomized clinical trials.

METHODS:

We performed the systematic search and meta-analysis for the randomized clinical trials of the CNI treatment in IgA nephropathy. The comparison between CNI combined with steroid and steroid-alone treatment was performed to find if the CNI combined with steroid can achieve more complete remission for IgA nephropathy. In addition, the related treatment effects were analyzed. After restricted selection, 16 studies with a total of 998 subjects with IgA nephropathy were enrolled. The focused outcome was complete remission, proteinuria, serum creatinine, and estimated glomerular filtration rate.

RESULTS:

The meta-analysis showed higher odds ratio of complete remission if the patients received CNI with steroid combined treatment. The proteinuria can be significantly reduced under the combined treatment of CNI and steroid. However, the CNI with steroid combined treatment showed a non-superior effect on the parameters of serum creatinine and estimated glomerular filtration rate.

CONCLUSIONS:

In current meta-analysis, the CNI combined with steroid treatment might show a trend to achieve complete remission status and reduce the proteinuria of IgA nephropathy when compared to steroid-alone treatment. However, no significant effects were observed in parameters of serum creatinine and estimated glomerular filtration rate.

• Authors: Zhong Li, ZhiQin Yang, MeiXue Ji
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 55 Issue 9 Pg. 2227-2236 (Sep 2023) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 36856924 (Publication Type: Meta-Analysis, Systematic Review, Journal Article, Review)
• Copyright: © 2023. The Author(s), under exclusive licence to Springer Nature B.V.

Chemical References

• Calcineurin Inhibitors
• Creatinine
• Immunosuppressive Agents
• Steroids

Topics

• Humans
• Glomerulonephritis, IGA (complications, drug therapy)
• Calcineurin Inhibitors (therapeutic use)
• Creatinine
• Immunosuppressive Agents (therapeutic use, pharmacology)
• Proteinuria (drug therapy, etiology)
• Steroids (therapeutic use)
• Glomerular Filtration Rate