Abstract: TH-PO136
Treatment of Membranous Glomerulopathy with Ponticelli’s Modified Scheme and with Cyclosporine Are Comparable after 1 Year of Follow-Up: Retrospective Cohort
Session Information
- Clinical Glomerular Disorders: FSGS, MN, MCD
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Glomerular
- 1005 Clinical Glomerular Disorders
Authors
- dos Anjos, Nathalia Campello Guedes, University Federal of Pernambuco, RECIFE, PERNAMBUCO, Brazil
- Sette, Luis H.B.C., UNIVERSIDADE FEDERAL DE PERNAMBUCO, Recife, Pernambuco, Brazil
- Oliveira, Camila Barbosa L., HOSPITAL DAS CLINICAS-UFPE, RECIFE, Brazil
- Costa, Denise Maria do nascimento, HOSPITAL DAS CLINICAS, RECIFE, Brazil
- Vajgel, Gisele, None, Recife, Brazil
- Cavalcante, Maria Alina G.M., Hospital das Clinicas - UFPE, Recife(PE) BRAZIL, Brazil
- Valente, Lucila Maria, None, Recife, Brazil
Background
The standard treatment recommended by KDIGO in patients with membranous glomerulopathy (MN) is performed with corticosteroids and cyclophosphamide (modified Ponticelli’s scheme). However, there are few studies in the Latin American population about the comparative efficacy of an alternative regimen using oral cyclosporine (CSA). The hypothesis is CSA presents therapeutic equivalence and lower side effects when compared to Ponticelli’s scheme. Therefore, this study sought to evaluate the response of these two therapeutic regimens in patients with MN.
Methods
a retrospective cohort was conducted from 1998 to 2016. Data from patients older than 18 years with idiopathic MN for at least 6 months without previous treatment ,were analyzed. In addition to the clinical and epidemiological profile, the response to the treatment was evaluated (CyA and Ponticelli), in a period of 6 months and 1 year after initiation of therapy. Definitions of partial response, complete response, relapse, and therapeutic failure were based on KDIGO.
Results
Thirty patients were evaluated 16 were treated with CSA and 14 with Ponticelli's scheme. The baseline characteristics of the two groups treated with IMS are described in Table 1. After 6 and 12 months the partial and complete response rate was 50% and 69% in the cyclosporine group and 57% and 50% in the Ponticelli's group. There was no difference between response rates (complete response and parcial response) between groups after 6 months (p = 0.69); 12 months (p = 0.64).
Conclusion
the therapeutic regimens of immunosuppression evaluated showed similar response rates after the 6-month and 12-month follow-up.
| Cyclosporine (n=16) | Ponticelli (n=14) | p | |
| Age (mean ± SD) | 40 ± 14.8 | 39 ± 16.2 | p=0.32 |
| Gender, male n(%) | 12 (75) | 9(64) | p=0.53 |
| Race | |||
| White | 10 (62.5) | 9 (64.2) | p=0.56 |
| non-white | 6 (37.5) | 5 (35.7) | p=0.42 |
| Proteinuria(g/24h) | 5.3 ± 4.7 | 5.2 ± 3.9 | p=0.58 |
| Serum albumin (g/dL) | 2.0 ± 0.7 | 1.8 ± 0.8 | p=0.36 |
| Scr (mg/dL) | 1.0 ± 0.4 | 1.1 ± 0.2 | p=0.32 |
| ACEi/ARBs | 100% | 100% | p=1 |
| Total colesterol (mg/dL) | 323±193 | 373 ± 119 | p=0.22 |