Kidney Week

Abstract: PO1631

Efficacy and Safety of a Combination Treatment of Mycophenolate Mofetil and Corticosteroid in Advanced IgA Nephropathy: A Multicenter, Prospective Study

Session Information

• Glomerular Diseases: Treatment and Outcomes
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

• Jung, Chan-Young, Yonsei University College of Medicine, Seoul, Seoul, Korea (the Republic of)

Chan-Young Jung, MD

• Han, Sang Youb, Inje University Ilsan Paik Hospital, Goyang, Korea (the Republic of)

Sang Youb Han,

• Kim, Beom seok, Yonsei University College of Medicine, Seoul, Seoul, Korea (the Republic of)

Beom seok Kim,

Background

It remains unclear whether immunosuppressive agents are effective in patients with IgA nephropathy (IgAN). We sought to determine the efficacy of mycophenolate mofetil (MMF) and corticosteroid combination therapy in patients with advanced IgAN.

Methods

We conducted a multicenter, randomized, placebo-controlled, parallel group study of a 48-week administration of MMF and corticosteroids in biopsy-proven advanced IgAN patients with an estimated glomerular filtration rate (eGFR) between 20-50 mL/min/1.73m² and a urine protein-to-creatinine ratio (UPCR) greater than 0.75g/day. The primary outcome was complete (UPCR<0.3g/day) or partial remission (reduction of UPCR >50% compared to baseline) at 48 weeks.

Results

Of the 48 randomized patients, complete and partial remission rates were higher in the MMF and corticosteroid combination therapy group (29.1% vs. 5.0%, P=0.05). In contrast to the combination therapy group, eGFR in the control group significantly decreased from 36 weeks onwards, resulting in a final adjusted mean change of -4.39 ± 1.22 mL/min/1.73m² (P=0.002). The adjusted mean changes at 48 weeks were 0.62 ± 1.30 and -5.11 ± 1.30 mL/min/1.73m² (P=0.005) in the treatment and control groups, respectively. The amount of UPCR was also significantly different between the two groups, where the adjusted mean difference was -0.47 ± 0.17 mg/mgCr in the treatment group and 0.07 ± 0.17 mg/mgCr in the control group (P=0.04). Overall adverse events did not differ between the groups.

Conclusion

In patients with advanced IgAN with a high risk for disease progression, combination therapy of MMF and corticosteroid appears to be beneficial in reducing proteinuria and preserving renal function.