ESPN 50th Annual Meeting

ESPN 2017


 
New combination therapy with prednisolone (PSL), mizoribine and lisinopril for severe childhood IgA Nephropathy (IgAN)
NORISHIGE YOSHIKAWA 1 YUKO SHIMA 2 MASASHI SATO 2 HAMA TAKETSUGU 2 HIRONOBU MUKAIYAM 2 HIROKO TOGAWA 2 HIROYUKI SUZUKI 2 HIROSHI KAITO 3 KANDAI NOZU 3 KAZUMOTO IIJIMA 3 KOICHI NAKANISHI 4

1- CLINICAL RESEARCH CENTER, TAKATSUKI GENERAL HOSPITAL & CLINICAL RESEARCH CENTER, WAKAYAMA MEDICAL UNIVERSITY
2- DEPARTMENT OF PEDIATRICS, WAKAYAMA MEDICAL UNIVERSITY
3- DEPARTMENT OF PEDIATRICS, KOBE UNIVERSITY GRADUATE SCHOOL OF MEDICINE
4- DEPARTMENT OF PEDIATRICS, RYUKYU UNIVERSITY GRADUATE SCHOOL OF MEDICINE
 
Introduction:

Angiotensin converting enzyme inhibitors such as lisinopril has been widely used for childhood IgAN since 2000s. To determine the benefits and harms of the treatment with the combination of PSL, mizoribine and lisinopril (new therapy) compared with the combination of PSL, mizoribine, warfarin and dipyridamole (previous therapy) for severe childhood IgAN.

Material and methods:

Retrospective analyses of 34 consecutive biopsy-proven severe IgAN children from August 1998 to November 2016 to compare clinicopathological findings between the 11 children treated with new therapy and 23 cases with previous therapy.

Results:

There was no significant difference in onset mode and clinical findings at the start of treatment. As to the pathological findings by Oxford classification, there were significant differences in ratio of M1 (64 vs. 96%, p=.03) and C1+C2 (100 vs 70%, p=.04). During the observation period, proteinuria remission was found in all cases with new therapy and 20 cases (87%) with previous therapy. The Kaplan-Meier analysis of proteinuria remission showed that patients with new therapy achieved significantly faster proteinuria remission than those with previous therapy (2.8M vs. 7.3M, p=.005).

Conclusions:

We confirmed the usefulness of new therapy for severe childhood IgAN. Long term outcome will be needed for further investigation.