Kidney Int:小剂量糖皮质激素联合霉酚酸钠与标准大剂量糖皮质激素治疗成人微小病变肾病综合征的比较

2021-09-10 从医路漫漫 MedSci原创

成人微小病变肾病综合征(MCNS)的一线治疗主要是从儿科研究中推断出来的,包括大剂量口服糖皮质激素

目的:成人微小病变肾病综合征(MCNS)的一线治疗主要是从儿科研究中推断出来的,包括大剂量口服糖皮质激素。我们评估了小剂量糖皮质激素联合霉酚酸钠是否优于标准的口服糖皮质激素方案。 方法:我们在一项包括32个法国中心的开放式随机对照试验中招募了116名MCNS成人患者。参与者被随机分配到实验组(n[58]),接受小剂量泼尼松(0.5 mg/kg/天,最大40 mg/天)加肠溶霉酚酸钠720 mg,每天两次,连续使用24周,第8周后未达到完全缓解的患者可采用二线方案(增加强的松剂量至1 mg/kg/天,联合或不联合环孢素)。其他参与者被随机分配到对照组(n[58]),接受常规大剂量泼尼松(1 mg/kg/天,最大80 mg/天),连续使用24周。 结果:109名参与者在治疗4周后确定了完全缓解的主要终点,试验组和对照组之间没有显著差异。次要结果包括治疗8周和24周后的缓解率,两组之间没有差异。在52周的随访中,15名(23.1%)达到主要疗效的患者存在MCNS复发。试验组和对照组的中位复发时间相似(分别为7.1个月和5.1个月),严重不良事件的发生率也相似。5例患者死于出血(n[2])或败

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    2022-01-04 pyaili
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time=2021-09-12, status=1, ipAttribution=)]
    2021-09-13 ms4000001886512548

    不错

    0

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    2021-09-12 gwc389

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