Research Article
ACTH Treatment for Management of Nephrotic Syndrome: A Systematic Review and Reappraisal
Table 7
Summary of studies on ACTH in minimal change disease.
| Study | N | Study protocol | Mean initial lab values | Study outcome | Complications |
| Minimal change disease (MCD) |
| Madan et al. [2] | 2 | Acthar gel: 80 units twice weekly for 6 months. | SrA: 2.1–3.7 g/dL SCr: 0.9–1.0 mg/dL Proteinuria: 2000–1500 mg/d | SrA:2.3–4.7 g/dL SCr: 0.7–1.2 mg/dL Proteinuria: 89–241 mg/d 98.1% reduction in proteinuria 2 complete remissions | None | Filippone, et al. [3] | 3 | Acthar gel: 40 units four times a week (n = 2) or 80 units twice weekly (n = 8) | SCr: 0.7–1.3 mg/dL Proteinuria: 3.2–12.4 g/g | SCr: 0.51–1.39 mg/dL Proteinuria: 0.270–0.918 g/g 2 partial remissions 1 complete remission | None | Bomback et al. [4] | 2 | Acthar gel: 40 units twice weekly for 2 week then 80 units twice weekly for 24 weeks | SCr: 0.6–0.7 mg/dL SrA: 2.5–3.4 g/dL UPCR: 3.16–4.76 g/g | SCr: 0.5–0.6 mg/dL SrA: 2.4–3.7 g/dL UPCR: 0.78–11.35 g/g 1 partial remission | None | Bomback et al [5] | 1 | Acthar gel: 80 units twice weekly for 4 months | Proteinuria: 18,553 mg/day | Proteinuria: 18,557 mg/day | None | Khastgir et al. [6] | 2 | Acthar gel: 80 units twice weekly for 6 months | N/A | 2 complete remissions | N/A | Berg and Arnadottir [7] | 2 | 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: 6747 mg/day | Proteinuria: 277.5 mg/day 2 complete remissions | None | Lorusso et al [15] | 2 | Synthetic ACTH: 1 mg once a week for 12 months | SrA: 2.4–3.4 g/dL Proteinuria: 3.0–3.9 g/d | SrA: 2.5–4.2 g/dL Proteinuria: 0.5–6.3 g/d n = 1 complete remission | None |
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ACTH, adrenocorticotropic hormone; eGFR, estimated glomerular filtration rate; SCr, serum creatinine; SrA, serum albumin; UPCR, urine protein creatinine ratio.
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