Abstract: TH-PO1036
Using the Oxford Classification in Assessing the Therapeutic Effects in IgA Nephropathy: A Secondary Analysis from a Randomized Clinical Trial
Session Information
- Glomerular Diseases: Clinical, Outcomes, Trials - I
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Duan, Shuwei, Department of Nephrology, State Key Laboratory of Kidney Disease, Beijing, China
- Cai, Guangyan, Chinese PLA Genaral Hospital, Beijing, BEIJING, China
- Chen, Xiangmei, Chinese PLA General Hospital, Beijing, BEIJING, China
Background
The Oxford Classification established a consensus on pathologic features that could predict the risks of progression of IgA nephropathy(IgAN). Clinically, histopathology is essential for both evaluating the severity of the lesions and guiding therapeutic strategies for IgAN. It remains a challenge whether or not Oxford Classification can guide therapeutic strategies. The aim of the analysis was to evaluate if the oxford classification can predict the therapeutic effects for patients receiving telmisartan and/or clopidogrel with/without leflunomide.
Methods
The multicentre, prospective, double-blind, double-dummy RCT was conducted between July 2010 and June 2012 in Beijing, China. The results were published in Chinese Medical Journal in 2016.
There were 162 cases, who were diagnosed in Chinese PLA General hospital, included in this secondary analysis. The complete or partial remission was defined as 24 hour proteinuria <0.3g or ≥30% reduction and stable kidney function. Stable kidney function was defined as increase in serum creatinine less than 26.4umol/L at week 24. The other was defined as ineffectiveness.
The logistical regression was used to analyse the relationship between the character of Oxford classification and the effect.
Results
Multiple logistic regression analysis showed that both of 24 hour proteinuria≥1g (Odds Ratio(OR)=2.13, 95%CI 1.04-4.36) and taking leflunomide(OR=5.70, 95%CI 2.66-12.24) were the advantage factors. Only tubular atrophy/interstitial fibrosis >50% were the risk factor(OR=18%, 95%CI 8%-40%). Especially, we found that there were interaction between mesangial hypercellularity >0.5 and leflunomide.
Conclusion
This secondary analysis supports the oxford classification for IgAN has capacity to predict the therapeutic effects for patients receiving telmisartan with leflunomide. Mesangial hypercellularity >0.5 maybe the potential character of taking leflunomide.
Funding
- Government Support - Non-U.S.