Which other medications are used in the treatment of IgA nephropathy?

Updated: May 19, 2020
  • Author: Sohail Abdul Salim, MD, FASN, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

See the list below:

  • Mycophenolate mofetil: Not effective in Americans or Europeans; possibly useful in Asians.
  • Azathioprine: Ineffective and possibly even harmful
  • Calcineurin Inhibitors: Possibly effective; nephrotoxic and not studied in randomized controlled trials
  • Adrenocorticotropic hormone (ACTH) gel (Acthar gel): A prospective pilot study of ACTH gel in a dose of 80 units subcutaneously twice weekly for 6 months reported that patients with  urinary protein >1 g/24-hour and eGFR >30 ml/min had a significant reduction in 24-hour urinary protein with stable eGFR at 12-month follow-up [43]
  • Hydroxychloroquine: A randomized controlled study with 30 patients in each arm demonstrated that when added to optimized renin-angiotensin-aldosterone system inhibition, hydroxychloroquine significantly reduced proteinuria in patients with IgA nephropathy over 6 months without evidence of adverse events; however, the short treatment period and lack of post-withdrawal observations limit conclusions about long-term efficacy and safety. [44]
  • Cyclophosphamide: Effective in 1 small controlled study in patients with crescentic disease [45] ; efficacy not confirmed in the STOP-IgAN trial, which excluded crescentic disease

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