|
| Study | N | Study protocol | Mean initial lab values | Study outcome | Complications |
|
| Focal segmental glomerulosclerosis (FSGS) |
|
| Madan et al. [2] | 15 | Acthar gel: 40–80 units every 24 to 72 hours for minimum of 24 weeks | SrA: 1.7–3.9 g/dL (3.17 ± 0.54)
SCr: 0.9–4.8 mg/dL, 2.27 ± 1.16
proteinuria: 2500–9306 mg/d (5238 ± 1975 mg/d) | SrA: 2.7–4.0 g/dl (3.56 ± 0.13)
SCr: 0.8–6.7 mg/dl (1.77 ± 0.64)
proteinuria: 750–3560 mg/d (2216 ± 1000 mg/d)
Mean 57.7% reduction in proteinuria 9 partial remissions | Increased swelling n = 1; Hypoalbuminemia in 8/15 patients; improvement in 7 by posttreatment;
2 early terminations |
| Tumlin et al. [21] | 13 | Acthar gel: 40–80 units, 2 to 3 times per week for 6 months | SCr: 1.8 ± 0.2 mg/dL
eGFR: 47 ± 6.8 mL/min/1.73m2
UP/Cr ratio: 7.92 ± 1.1 g/g
Proteinuria: 6.47 ± 1.2 g/g | eGFR: 52.3 ± 8 mL/min/1.73 m2 UPCR ratio: 2.98 ± 0.6 g/g
Proteinuria: 1.51 ± 0.7 g/g
1 complete remission
8 partial responses | Hyperglycemia n = 5
Reduction on Acthar
n = 1 |
| Hogan et. al. [22] | 24 | Acthar gel: n = 12: 40 u weekly for 2 weeks then 80 units weekly for 2 weeks
80 units biweekly for 12 weeks n = 7: 40 units biweekly for 2 weeks
80 units biweekly for 22 weeks n = 5: 80 units SC twice weekly | Median proteinuria: 4595 mg/g (IQR, 2200–8020)
SCr: 2.0 mg/dL (IQR, 1.1–2.7)
eGFR: 36 mL/min per 1.73 m2 (IQR, 28–78) | Median proteinuria: 2243 mg/g (IQR, 1570–5620)
SCr: 1.4 mg/dL (IQR, 1.1–2.0)
eGFR: 45 mL/min per 1.73 m2 (IQR, 28–74)
5 partial remissions
2 complete remissions | 21 patients had adverse effects: swelling (n = 5), mood alteration (n = 4), elevated blood pressure (n = 3), dyspepsia (n = 2), hyperglycemia (n = 1), upper respiratory infection (n = 4), muscle cramps (n = 4), polyurea (n = 1), rash (n = 2). |
| Alhamad et al. [23] | 20 | Acthar gel: 80 units twice a week for 6 months | SCr: 3.3 ± 2.7 mg/dl
SrA: 3.6 g/g
eGFR: 30.7 ± 19.3 mL/min/1.73 m2
proteinuria: 8.8 ± 7.6 g/g | SCr: 2.8 ± 1.67 mg/dl
SrA: 3.7 g/g
eGFR: 34.4 ± 20 mL/min/1.73 m2
proteinuria: 3.3 ± 2.3 g/g
4 complete remissions
6 partial remissions | 8 reports of graft failure |
| Bomback et al. [5] | 1 | Acthar gel: 80 units twice a week for 6 months | Proteinuria: 10275 mg/day | Proteinuria: 2970 mg/day
1 partial remission | None |
| Bomback et al. [4] | 3 | Acthar gel: 40 units twice a week for 2 week and 80 units twice a week for 24 weeks | SCr: 1.0 mg/dL
SrA:3.37 g/dL
UPCR: 1.85 g/g
Proteinuria: 1.85 g/g | SCr: 1.13 mg/dL
SrA: 3.33 g/dL
UPCR: 2.15 g/g
Proteinuria: 2.14 g/g
1 partial remission | Temporary increase in skin pigmentation n = 1 |
| Fillippone et al. [3] | 10 | Acthar gel: 40 units weekly (n = 2) or
80 units twice weekly (n = 8) | SCr: 2.22 mg/dL
Proteinuria: 5.8–8.43 g/d | SCr: 2.12 mg/dL
Proteinuria:6 observed reduction in proteinuria
2 partial remissions
2 complete remissions | 1 patient withdrew due to side effects
Weight gain n = 4
Myalgia n = 2
Worsening diabetes n = 2
Hypertension n = 2
Edema n = 1 |
| Berg et al. [24] | 10 | Synthetic ACTH: 1 mg once a week for 6 months | Proteinuria: 3400 mg/d | Proteinuria: 1700 mg/d
1 partial remission | N/A |
| Lorusso et al. [15] | 2 | Synthetic ACTH: 1 mg once a week for 12 months | SrA: 2.5 g/dL
Proteinuria: 18 g/d | SrA: 3 g/dL
Proteinuria: 0.93 g/d | N/A |
|
