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"STOP-IgAN"

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https://www.readbyqxmd.com/read/29695925/primary-iga-nephropathy-current-challenges-and-future-prospects
#1
REVIEW
Rose S Penfold, Maria Prendecki, Stephen McAdoo, Frederick Wk Tam
IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide, exhibiting a variable clinical and pathological course and significantly contributing to the global burden of chronic kidney disease and end-stage renal disease. Current standards of care focus on optimization of antihypertensive and antiproteinuric therapies (typically renin- angiotensin system blockade) to reduce disease progression. Much recent attention has focused on whether additional immunosuppression confers better outcomes than supportive management alone, and indeed, several trials have demonstrated renoprotective effects following the use of oral corticosteroids...
2018: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/29606258/treatment-of-iga-nephropathy-recent-advances-and-prospects
#2
REVIEW
Rosanna Coppo
IgA nephropathy, identified 50 years ago in France, is the most frequent glomerular disease worldwide. The course is variable, but in most of the cases there is a relentless decline in renal function, reaching end-stage renal failure in 10-60% of the cases after 10 years and in 40% after 20 years. These data justify the interest for finding a suitable therapeutic approach particularly in progressive cases. A supportive care, including renin-angiotensin system inhibitors is the priority in cases with slowly declining renal function, particularly when developing proteinuria...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29539619/ctla-4-polymorphisms-in-patients-with-iga-nephropathy-correlate-with-proteinuria
#3
Marius Jacob, Kim Ohl, Tannaz Goodarzi, Sigrid Harendza, Thomas Eggermann, Christina Fitzner, Ralf-Dieter Hilgers, Anna Bolte, Jürgen Floege, Thomas Rauen, Klaus Tenbrock
BACKGROUND/AIMS: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis and still constitutes one of the most important causes of end-stage renal disease. Abnormal T cell responses may play a role in IgAN pathogenesis. Co-stimulatory molecules such as cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) are important for naive T cells to initiate and terminate immune responses. Single nucleotide polymorphisms (SNPs) in the CTLA4 gene locus are associated with several autoimmune diseases...
March 8, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29199436/-considerations-on-the-treatment-of-iga-nephropathy-on-the-basis-of-the-results-of-the-latest-studies-stop-igan-testing-nefigan
#4
Judit Nagy, Balázs Sági, Judit Máté, Tibor Vas, Tibor Kovács
IgA nephropathy is an immune-mediated chronic glomerulonephritis with a great variability in clinical presentation and outcome. The disease can progress to end-stage renal failure in 25% of patients. For this reason we should identify patients with potential to progress. Most important risk factors for progression are persistent proteinuria, hypertension, decreased renal function and some histological lesions. The actually suggested treatment is summarized in KDIGO Clinical Practice Guideline from 2012. They suggest to give firstly non-specific supportive treatment (especially renin-angiotensin system blocking agents)...
December 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29042456/effects-of-two-immunosuppressive-treatment-protocols-for-iga-nephropathy
#5
Thomas Rauen, Christina Fitzner, Frank Eitner, Claudia Sommerer, Martin Zeier, Britta Otte, Ulf Panzer, Harm Peters, Urs Benck, Peter R Mertens, Uwe Kuhlmann, Oliver Witzke, Oliver Gross, Volker Vielhauer, Johannes F E Mann, Ralf-Dieter Hilgers, Jürgen Floege
The role of immunosuppression in IgA nephropathy (IgAN) is controversial. In the Supportive Versus Immunosuppressive Therapy for the Treatment of Progressive IgA Nephropathy (STOP-IgAN) Trial, 162 patients with IgAN and proteinuria >0.75 g/d after 6 months of optimized supportive care were randomized into two groups: continued supportive care or additional immunosuppression (GFR≥60 ml/min per 1.73 m2 : 6-month corticosteroid monotherapy; GFR=30-59 ml/min per 1.73 m2 : cyclophosphamide for 3 months followed by azathioprine plus oral prednisolone)...
January 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28863793/immunosuppression-in-iga-nephropathy-guideline-medicine-versus-personalized-medicine
#6
REVIEW
John Feehally
The role of immunosuppression in IgAN remains controversial despite a growing evidence base of randomized controlled trials (RCTs). In IgAN with nephrotic syndrome the role for corticosteroids is limited to cases with minimal change on light microscopy. In crescentic IgAN, the use of immunosuppression is supported only by anecdotal data, and outcome may be poor especially when glomerular filtration rate is impaired severely at presentation or there are pathologic features of chronic injury. In slowly progressive IgAN, prediction of outcome now is based both on clinical and pathologic features...
September 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28399021/an-update-on-the-treatment-of-iga-nephropathy
#7
REVIEW
Sean Barbour, John Feehally
PURPOSE OF REVIEW: The treatment of IgA nephropathy (IgAN) has been limited by several controversies in the literature, including the benefits of corticosteroids in addition to optimized renin-angiotensin system blockers (RASBs), in those with lower estimated glomerular filtration rate (eGFR), or in different ethnic groups. Recent studies have attempted to address these issues. RECENT FINDINGS: Two observational studies suggest the efficacy of corticosteroids in those with lower eGFR, but with a higher risk of adverse events...
July 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27929572/what-does-stop-igan-tell-us-about-how-to-treat-iga-nephropathy
#8
S Piracha, J Gnanapragasam, S M Tariq
Bronchoesophageal fistulae are a rare complication of tuberculosis. Traditionally they are managed by either thoracotomy with resection and closure of the fistulous tract or by taking a more conservative approach of giving standard treatment for tuberculosis while ensuring nutritional support through a nasogastric tube. We report a young student with disseminated tuberculosis complicated by a bronchoesophageal fistula. He was managed conservatively with anti-tuberculous chemotherapy and nutrition administered through a percutaneous endoscopic gastrostomy tube...
June 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27765465/-do-stop-igan-results-mean-stop-steroids-in-iga-nephropathy
#9
RANDOMIZED CONTROLLED TRIAL
Perrine Jullien, Christophe Mariat, Nicolas Maillard
No abstract text is available yet for this article.
December 2016: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/27515695/moderator-s-view-treatment-of-iga-nephropathy-getting-comfortable-with-uncertainty
#10
COMMENT
Richard J Glassock
A Polar Views discussion by Pozzi and Rauen et al. on the interpretation and clinical application of the recently published Supportive Versus Immunosuppressive Therapy of Progressive IgA Nephropathy (STOP-IgAN) trial has elucidated important points concerning potential strengths and weaknesses of this landmark randomized trial. This critical examination of the impact of steroid monotherapy or steroid plus an immunosuppressive (IS) agent compared with 'supportive' therapy with inhibitors of the renin-angiotensin system (RAS) has enhanced our appreciation of the importance of rigorous application of titrated RAS inhibition in high-risk patients with persistent proteinuria >0...
November 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27515694/pro-stop-immunosuppression-in-iga-nephropathy
#11
Claudio Pozzi
The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines suggest a 6-month course of corticosteroids (CS) for IgA nephropathy (IgAN) patients with persistent proteinuria ≥1 g/day despite 3-6 months of renin-angiotensin system (RAS) blockers and glomerular filtration rate (GFR) >50 mL/min/1.73 m2 In December 2015, Rauen et al. (N Engl J Med 2015; 373: 2225-2236) published an article entitled 'Intensive supportive care plus immunosuppression in IgA nephropathy' (STOP-IgAN), which presented results from 379 IgAN patients from 32 nephrology centres in Germany...
November 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27515693/con-stop-immunosuppression-in-iga-nephropathy
#12
Thomas Rauen, Frank Eitner, Christina Fitzner, Jürgen Floege
A comprehensive supportive therapy approach constitutes the mainstay treatment of IgA nephropathy (IgAN) patients. In our recent Supportive versus immunosuppressive Therapy Of Progressive IgA Nephropathy (STOP-IgAN) trial, we systematically selected for patients at high risk of a progressive disease course and evaluated the effect of immunosuppression, combined with supportive care, on renal end points in these patients. There was a higher rate of full clinical remission and transient proteinuria reduction in immunosuppressed patients...
November 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27476075/spleen-tyrosine-kinase-a-crucial-player-and-potential-therapeutic-target-in-renal-disease
#13
REVIEW
Terry King-Wing Ma, Stephen P McAdoo, Frederick Wai-Keung Tam
Spleen tyrosine kinase (Syk), a 72 kDa cytoplasmic non-receptor protein-tyrosine kinase, plays an important role in signal transduction in a variety of cell types. Ever since its discovery in the early 1990s, there has been accumulating evidence to suggest a pathogenic role of Syk in various allergic disorders, autoimmune diseases and malignancies. Additionally, there is emerging data from both pre-clinical and clinical studies that Syk is implicated in the pathogenesis of proliferative glomerulonephritis (GN), including anti-glomerular basement membrane disease, anti-neutrophil cytoplasmic antibody-associated GN, lupus nephritis and immunoglobulin A nephropathy (IgAN)...
2016: Nephron
https://www.readbyqxmd.com/read/27443481/immunosuppressive-therapy-for-active-iga-nephropathy-is-effective-and-safe-even-in-elderly-patients
#14
Michio Fukuda, Osamu Hotta, Masashi Mizuno, Yoshiaki Ogiyama, Nobuyuki Ohte
Proportions of elderly aged ≥65 and ≥75 within Japan will increase to 30 and 20 %, respectively, in 2025, when "Baby-Boom Generations" will reach the age of 75 years. Okabayashi and colleagues report that even in elderly patients with IgA nephropathy (IgAN), immunosuppressive treatment can reduce proteinuria, with no adverse events. Their findings remind us of recent finding from STOP-IgAN study; additional immunosuppressive therapy to intensive supportive care [specifically renin-angiotensin system (RAS) inhibitors (RASi)] did not improve the outcome...
December 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27092366/what-does-stop-igan-tell-us-about-how-to-treat-iga-nephropathy
#15
E Rutherford, P B Mark
No abstract text is available yet for this article.
March 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/26962739/intensive-supportive-care-plus-immunosuppression-in-iga-nephropathy
#16
LETTER
F Paolo Schena, Carlo Manno
No abstract text is available yet for this article.
March 10, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26962738/intensive-supportive-care-plus-immunosuppression-in-iga-nephropathy
#17
LETTER
Isabelle Ayoub, Lee Hebert, Brad H Rovin
No abstract text is available yet for this article.
March 10, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26962737/intensive-supportive-care-plus-immunosuppression-in-iga-nephropathy
#18
LETTER
Thomas Robert, Alexandra Cambier, Alexandre Hertig
No abstract text is available yet for this article.
March 10, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26962736/intensive-supportive-care-plus-immunosuppression-in-iga-nephropathy
#19
LETTER
Jürgen Floege, Thomas Rauen, Frank Eitner
No abstract text is available yet for this article.
March 10, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26763671/highlights-of-the-2015-era-edta-congress-glomerular-diseases
#20
REVIEW
Jürgen Floege
The present paper summarizes highlights in the field of glomerular diseases presented at the 2015 European Renal Association congress in London. Topics covered include a European survey on renal biopsy practice and indications, the STOP-IgAN randomized controlled trial in patients with IgA-nephropathy, B-cell- targeting therapies in minimal change nephropathy and focal segmental glomerulosclerosis (FSGS), novel insights into the action of glucocorticosteroids in glomerular crescent and scar (FSGS) formation, the immunoproteasome in IgA-nephropathy, socio-economic factors and glomerular disease progression, glomerular CD80 (B7-1) expression in FSGS patients and aldosterone-antagonism in proteinuric renal diseases...
February 2016: Nephrology, Dialysis, Transplantation
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