Real-word adrenocorticotropic hormone treatment for childhood-onset nephrotic syndrome Article Swipe
Ying Wang
,
Xiqiang Dang
,
Xiaochuan Wu
,
Yongzhen Li
,
Qingnan He
,
Xiaoyan Li
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fped.2023.1044075
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fped.2023.1044075
Background Current first-line anti-proteinuric treatments do not produce a satisfactory therapeutic effect in a considerable number of patients with nephrotic syndrome (NS). Interest in adrenocorticotropic hormone (ACTH) for the treatment of NS has recently been revived. The present study investigated the efficacy and safety of ACTH treatment in children with frequent relapsing NS (FRNS), steroid-dependent NS (SDNS), and steroid-resistant NS (SRNS). Method The ACTH treatment group was comprised of NS patients receiving ACTH treatment. Patients with serum cortisol concentrations <85.3 nmol/L and who had not received ACTH treatment previously were enrolled in the control group from January 2018 to January 2021. The maintenance dose of prednisone, the number of disease recurrences, the time of first disease relapse, immunosuppressant use, serum cortisol levels, and adverse events were recorded in both groups. Results Fifty-one patients were included in the ACTH group, and twenty-one patients were enrolled in the control group. Concurrent treatment with one or more immunosuppressive and/or cytotoxic treatments occurred in 92.2% and 85.7% of patients in the ACTH and control groups, respectively, throughout the study period. A greater reduction in the prednisone maintenance dose was observed in the ACTH group compared with the control group after 1 year of follow up (0.603 ± 0.445 mg/kg vs. 0.267 ± 0.500 mg/kg, p = 0.006). During the one-year study period, fewer participants experienced one or more disease relapses in the ACTH group (45.1%) compared to the control group (76.2%, odds ratio = 3.896, p = 0.016). The number of disease recurrences per patient in the ACTH group was less than that in the control group (median difference = −1, p = 0.006). The mean length of remission was 8.902 m and 7.905 m in the ACTH group and control group, respectively. A log-rank test showed a longer relapse free survival for patients in the ACTH group ( p = 0.046), but the Breslow test showed no significant difference between groups ( p = 0.104). Ten patients in the ACTH group successfully discontinued all drug therapies. No patients in the control group were able to discontinue drug therapy as of February 2022. Conclusion ACTH, combined with multiple drugs, is effective at reducing the prednisone maintenance dose and may effectively prevent disease relapses in childhood NS.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fped.2023.1044075
- OA Status
- gold
- Cited By
- 4
- References
- 39
- Related Works
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- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4323668141Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fped.2023.1044075Digital Object Identifier
- Title
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Real-word adrenocorticotropic hormone treatment for childhood-onset nephrotic syndromeWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-03-09Full publication date if available
- Authors
-
Ying Wang, Xiqiang Dang, Xiaochuan Wu, Yongzhen Li, Qingnan He, Xiaoyan LiList of authors in order
- Landing page
-
https://doi.org/10.3389/fped.2023.1044075Publisher landing page
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.3389/fped.2023.1044075Direct OA link when available
- Concepts
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Medicine, Adrenocorticotropic hormone, Nephrotic syndrome, Pediatrics, Internal medicine, Hormone, EndocrinologyTop concepts (fields/topics) attached by OpenAlex
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4Total citation count in OpenAlex
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2024: 4Per-year citation counts (last 5 years)
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39Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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