Research Article
ACTH Treatment for Management of Nephrotic Syndrome: A Systematic Review and Reappraisal
Table 9
Summary of studies on ACTH in IgA nephropathy.
| Study | N | Study protocol | Mean initial lab values | Study outcome | Complications |
| IgA nephropathy (IgAN) |
| Bomback et al. [5] | 1 | Acthar gel: 40 units twice per week for 8 months | Proteinuria: 4952 mg/day | Proteinuria: 42 mg/day 1 complete response | None | Bomback et al. [4] | 5 | Acthar gel: 40 units twice per week for 2 weeks then 80 units twice per week for 6 months | SCr: 0.8–2.7 mg/dl SrA: 3.7–4.3 g/dl UPCR: 0.61–1.95 g/g | SCr: 0.8–2.1 mg/dl SrA: 4.1–4.5 g/dl UPCR: 0.21–1.22 g/g 1 complete response 1 partial response | n = 1 weight gain, cushingoid facies, increased blood pressure; Withdrawn due to worsening kidney function | Madan et al. [2] | 5 | Acthar gel: 80 units twice weekly for 6 months | SCr: 1.0–2.8 mg/dl SrA: 3.0–2.0 g/dl Proteinuria 2500–9306 mg/d (4268 ± 2931 mg/d) | SCr: 1.0–1.5 mg/dl SrA: 3.6–4.2 g/dl Proteinuria: 800–2360 mg/d (1416 ± 654 mg/d) 67.3% reduction in proteinuria 2 partial remissions | 1 early termination (n = 1) weight gain (n = 1) hypertension | Khastgir et al. [6] | 5 | Acthar gel: 80 units twice weekly for 6 months | N/A | 2 partial remissions 36.4% proteinuria reduction | 1 early termination due to hypertension and weight gain | Zand et al. [24] | 19 | Acthar gel: 80 units twice weekly for 6 months | SCr: 1.40 ± 0.49 mg/dl SrA: 3.79 ± 0.54 g/dl 24 hr UP: 2635 (1230–5243) mg | SCr: 1.55 ± 0.64 mg/dl SrA: 3.93 ± 0.39 g/dl 24 hr UP: 1274 (344–6228) mg 8 partial remissions | 6 infections: 2 viral, 2 sinusitis, 1 pneumonia, 1 otitis media |
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SCr, serum creatinine; SrA, serum albumin; UP, urine protein; UPCR, urine protein creatinine ratio.
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