title: Probucol combined with valsartan in immunoglobulin A nephropathy: a multi-centre, open labelled, randomized controlled study.
abstract: OBJECTIVE
  Angiotensin receptor antagonists (ARBs) and anti-oxidants reduce urinary protein excretion and delay progression of immunoglobulin A (IgA) nephropathy. We investigated the efficacy and safety of probucol (an anti-oxidant) combined with valsartan (an ARB) on the progression of IgA nephropathy.
  
  
  METHODS
  Patients with IgA nephropathy (n = 69) were recruited from five centres and randomly assigned to a treatment group (750 mg/day probucol plus 160 mg/day valsartan) or a control group (160 mg/day valsartan) and were followed for 3 years.
  
  
  RESULTS
  At baseline, the two groups in any measured clinical information were comparable. The primary endpoint (doubling serum creatinine) showed no significant difference between the two groups during 3-year follow-up. The secondary endpoint (50% reduction in 24-h urinary protein) occurred in 23 patients in the treatment group and 20 patients in the control group. The time to the secondary end-point was shorter in the treatment group than the control group (8.13 months vs 19.63 months, P = 0.019). However, at the 3-year follow-up, the 24-h urinary protein levels were not significantly different from the baseline levels (P = 0.99 and P = 0.66, respectively). At the 1-year follow-up, plasma cholesterol in the treatment group was markedly lower than in the control group (4.12 ± 1.28 vs 5.03 ± 1.01, P = 0.02).
  
  
  CONCLUSIONS
  Kidney function remained stable and there was no significant difference in two group patients. Probucol combined with valsartan led to a more rapid decrease of 24-h urinary protein excretion than valsartan alone. However, the long-term effect needs further investigation.
authors.affiliation: Southern Medical University, Guangzhou, China; Department of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Ye
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Lixia
authors.initials: L
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: Haitang
authors.initials: H
authors.lastname: Hu
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Shi
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Zhong
authors.forename: Shuan
authors.initials: S
authors.lastname: Hou
authors.forename: Honghong
authors.initials: H
authors.lastname: Yan
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Xia
authors.forename: Wenjian
authors.initials: W
authors.lastname: Wang
authors.forename: Zonglin
authors.initials: Z
authors.lastname: Feng
authors.forename: Liping
authors.initials: L
authors.lastname: Wang
authors.forename: Yongzheng
authors.initials: Y
authors.lastname: Liang
mesh_terms: D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D000975:Antioxidants / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011341:Probucol / Q000008:administration & dosage* / Q000009:adverse effects; D013777:Tetrazoles / Q000008:administration & dosage* / Q000009:adverse effects; D014633:Valine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000975:Antioxidants; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine; D011341:Probucol
keywords: IgA nephropathy; anti-oxidation; probucol; randomized controlled study; valsartan