Clinical Efficacy and Safety of Mycophenolate in the Treatment of Primary Refractory Nephrotic Syndrome

2021 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 223-228
Author(s):  
Yalda Ravanshad ◽  
◽  
Mohadeseh Golsorkhi ◽  
Sahar Ravanshad ◽  
Mohammad Esmaeeli ◽  
...  

Context: Different studies have been done so far on drug safety and efficacy in children with refractory nephrotic syndrome (NS). Ofatumumab might be an effective drug for this syndrome; however, the long-term effects and cost-effectiveness of ofatumumab treatment have not been comprehensively assessed.  Objectives: This study aims to perform a systematic review of the efficacy and safety of ofatumumab in children with difficult-to-treat NS. Study Selection: An electronic literature search was conducted to identify appropriate studies. The search key terms were as follows: (“nephrotic syndrome” OR “minimal change disease” OR “focal segmental glomerulosclerosis” OR “membranous”) AND (“Ofatumumab” or “CD20” or “Arzerra” or “HuMax-CD20”).  Data Extraction: Data were extracted from the articles according to the selection criteria by two independent reviewers. Results: A total of 83 potentially relevant articles were identified. Thirty-two articles were removed due to duplication. Then 26 more articles were excluded because they were book sections and review papers and therefore not relevant. Another 14 items were removed after reviewing the full text of selected papers because the topics did not fit our study subject. Finally, 11 studies were selected in our systematic review. The benchmark considered to assess the efficacy of ofatumumab in children with nephrotic syndrome in most of the studies was a complete remission rate. Conclusions: In conclusion, our systematic review showed that ofatumumab may be an effective drug in refractory NS treatment in children and could bring down the use of steroids and immunosuppressants. However, further large randomized trials are suggested.


2021 ◽  
Vol 6 (1) ◽  
pp. 101-109
Author(s):  
Elias Jatem ◽  
Joan Lima ◽  
Bruno Montoro ◽  
Francisco Torres-Bondia ◽  
Alfons Segarra

2014 ◽  
Vol 33 (2) ◽  
pp. A1-A2 ◽  
Author(s):  
Yo Han Ahn ◽  
Hee Gyung Kang ◽  
Seong Heon Kim ◽  
Kyoung Hee Han ◽  
Hee Yeon Cho ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-27
Author(s):  
Yan-Li Guo ◽  
Feng Gao ◽  
Tai-Wei Dong ◽  
Yang Bai ◽  
Qiao Liu ◽  
...  

Objective. Tripterygium wilfordii polyglycosides tablet (TGt) is an oral preparation extracted from plant Tripterygium wilfordii. It has the effects of anti-inflammation and inhibition of cellular and humoral immunity. However, many reports of adverse reactions caused by TGt have limited its application. In this paper, the clinical efficacy and safety of TGt in the treatment of chronic kidney disease (CKD) were verified by data mining and analysis, so as to provide theoretical data support for the application and development of TGt. Methods. A computer search of the following databases was conducted: PubMed, Web of Science, CBM, VIP, Wanfang Data, and CNKI. The search time limit is from the establishment of the database to September 2020. We searched for clinical randomized controlled trials of TGt in the treatment of CKD. The main types of CKD involved are nephrotic syndrome (NS), primary nephrotic syndrome (PNS), refractory nephrotic syndrome (RNS), and IgA nephropathy (IgAN). RevMan 5.2 and Stata 12.0 software were used to evaluate the literature quality and analyze the data. Finally, GRADEpro software was used to evaluate the quality of evidence. Results. According to the inclusion and exclusion criteria, 75 articles with a total of 6418 subjects were included. The results of the meta-analysis showed that TGt could reduce 24-hour urinary protein, increase serum albumin, improve clinical efficacy, and reduce disease recurrence rate in patients ( P < 0.05 ) with CKD compared with adrenocortical hormones or immunosuppressants. TGt could significantly reduce the level of serum creatinine (Scr) in patients with CKD ( P < 0.05 ), but it was not significant in reducing the level of blood urea nitrogen ( P > 0.05 ). In terms of safety evaluation, in patients with CKD, it could significantly reduce the incidence of gastrointestinal adverse reactions and neurogenic dizziness and headache ( P < 0.05 ). However, in terms of adverse reactions such as liver injury, respiratory infection, and leukopenia, TGt was as harmful as corticosteroids or immunosuppressants ( P < 0.05 ). The quality of the evidence was evaluated with GRADEpro software, and the results showed that TGt was strongly recommended for the treatment of CKD. Conclusion. TGt has certain efficacy in the treatment of CKD and has fewer side effects in certain types of diseases. The effect of TGt combined with other drugs is better than that of single use. This paper also has some limitations. Due to the limited number of the included studies, with all being from China, there may be methodological differences. Therefore, more high-quality literature data from different countries are needed.


2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Zhihong Zhao ◽  
Guixiang Liao ◽  
Yongqiang Li ◽  
Shulu Zhou ◽  
Hequn Zou

2020 ◽  
Vol 9 (5) ◽  
pp. 3170-3181
Author(s):  
Hui Xu ◽  
Xiaozhao Li ◽  
Xiangning Yuan ◽  
Qiongjing Yuan ◽  
Wenhang Chen ◽  
...  

2010 ◽  
Vol 16 (1) ◽  
pp. 38 ◽  
Author(s):  
Hong Ryeol Cheong ◽  
Hyun Young Woo ◽  
Jeong Heo ◽  
Ki Tae Yoon ◽  
Dong Uk Kim ◽  
...  

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