Meta-analysis of randomised controlled trials in patients with primary IgA nephropathy (Berger's disease).
An overview of the papers published in the last 10 years was performed to evaluate whether treatment with currently available drugs was beneficial in patients with primary IgA nephropathy (IgAN). Eight selected papers involving 196 IgAN patients with moderate or heavy proteinuria, associated in some cases with the nephrotic syndrome, were analysed. The criteria for inclusion were strict, because meta-analysis requires randomised controlled trials with full descriptions. Furthermore, papers were selected in which treatment was performed on IgAN patients with proteinuria, since prognosis is poor in the presence of this sign. The results of statistical analysis show that IgAN patients with heavy proteinuria, whether or not associated with the nephrotic syndrome, benefit from the administration of corticosteroids and/or cytotoxic drugs, as 66.7% of patients had complete or partial remission both in controlled trials and in retrospective studies; renal function also improved in treated patients. In contrast, no beneficial effect was observed in IgAN patients with moderate proteinuria. These results suggest that it is advisable to administer corticosteroids and/or cytotoxic drugs to IgAN patients with heavy proteinuria, irrespective of the association of this condition with the nephrotic syndrome in individual patients.
Schena
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FP
Chair of Nephrology, University of Bari, Italy.
Montenegro
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M
Scivittaro
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D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D006801:Humans; D015201:Meta-Analysis as Topic; D011507:Proteinuria / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents