ACTH Treatment for Management of Nephrotic Syndrome: A Systematic Review and Reappraisal

Table 10

Summary of studies on ACTH in membranoproliferative glomerulonephritis.

Study	N	Study protocol	Mean initial lab values	Study outcome	Complications
Membranoproliferative glomerulonephritis (MPGN)
Berg and Arnadottir [7]	6	Synthetic ACTH: 1 mg/wk or dose based on body weight (0.5/1 mg once a week or 0.75/1 mg twice a week)	Proteinuria: 5027–26660 mg/d (12,041 ± 7806 mg/d)	Proteinuria: 56–762 mg/day (392 ± 304 mg/d); 6 complete responses	N/A
Lorusso et al. [15]	2	Synthetic ACTH: 1 mg/wk for 12 months	SrA: 2.6–2.7 mg/dL; Proteinuria: 10–16 g/day (13 ± 3 g/d)	SrA: 4.4–4.5 mg/dL Proteinuria: 0.8–10.8 g/day (5.8 ± 5 g/d); 1 complete remission	1 early termination
Bomback et al. [5]	4	Acthar gel: 80 units twice per week (n = 3) or 40 units three times per week (n = 1) for 4–6 months	Proteinuria (80 U): 5500–13073 mg/d(9605 ± 3124 mg/d); Proteinuria (40 U): 12398 mg/day	Proteinuria (80): 3741–4825 mg/d(4148 ± 481 mg/d); 3 no response; Proteinuria (40): 4560 mg/d; Limited response	None
Madan et al. [2]	1	Patients received 80 U acthar gel twice weekly for 6 months	SCr: 0.7 mg/dl; SrA: 1.5 g/dl; Proteinuria 10000 mg/d	SCr: 0.8 mg/dl; SrA: 3.3 g/dl; Proteinuria: 2141 mg/d n = 1; Partial remission	None

ACTH, adrenocorticotropic hormone; SCr, serum creatinine; SrA, serum albumin.