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

ACTH, adrenocorticotropic hormone; eGFR, estimated glomerular filtration rate; SCr, serum creatinine; SrA, serum albumin; UPCR, urine protein creatinine ratio.