Abstract: FR-PO1048
Efficiency and Safety of Thalidomide Combined with Dexamethasone in Patients with Proliferative Glomerulonephritis with Monoclonal IgG Deposit
Session Information
- Glomerular Diseases: Immunology and Inflammation - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1202 Glomerular Diseases: Immunology and Inflammation
Authors
- Cheng, Zhen, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
- Liu, Zhihong, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
- Wei, Zhou, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
- Li, Juan, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
Background
To evaluate the efficacy and safety of thalidomide combined with dexamethasone (TD) in patients with proliferative glomerulonephritis with monoclonal IgG deposits(PGNMID).
Methods
We retrospectively analyzed the clinical data of 12 patients diagnosed with PGNMID from December 2015 to November 2017 in Jinling Hospital, who received TD regimen, and 32 PGNMID patients treated with non-TD regimen from 2011 to 2016.
Results
There are 4 males and 8 females with a median age of 48.5(27,63) yr taking the regimen of TD. With a mean follow-up of 7.5 mo, 6(50%) patients achieve renal response, including 2(16.7%) patients achieving complete response and 4(33.3%) patients achieving partial response, median time of response was 5.5 mo. 5(83.3%) patients got hematological response, in which 1(16.7%) patients obtain complete response, 2(33.3%) patients obtain very good partial response and 2(33.3%) patients obtain partial response. After treatment, serum albumin improved(P=0.002), serum creatinine kept stable(P=0.79), urine protein decreased(P=0.099), and no patient progressed to ESRD. One patient got histopathological recovery. During the secondary renal biopsy, the monoclonal IgG3 and κ light chain deposited in kidney disappeared completely, and glomerular nodular changes also improved. There was no statistical difference in clinical data between the two groups except for gender. With a mean follow-up of 19.2 mo in non-TD group, 5(15.6%) patients achieve renal response, including 3(9.4%) patients achieving complete responseand 2(6.3%) patients achieving partial response. The renal response rate was lower than those in TD group (P=0.045). 3 (33.3%) patients got hematological response. Serum creatinine in the last follow-up were worse than the baseline(P=0.046), albumin (P=0.005) and proteinuria (P=0.044) were improved, and 8(25%) patients progressed to ESRD with an average time of 25.2 mo. The common side effects of TD group were numbness (50%), edema (50%) and sleepiness (50%), but most of the patients were tolerable through symptomatic treatment and drug reduction.
Conclusion
The TD regimen is effective for PGNMID patients. Side effects are common but most of the patients can tolerate it.