Comparison of the effects of hydroxychloroquine and corticosteroid treatment on proteinuria in IgA nephropathy: a case-control study.

ABSTRACT: BACKGROUND:Hydroxychloroquine (HCQ), a well-known immunomodulator, has recently been found to be a promising and safe anti-proteinuric agent for treating IgA nephropathy (IgAN). We aimed to compare the efficacy and safety of HCQ and corticosteroid treatment in patients with IgAN. METHODS:This is a case-control study. Ninety-two patients with IgAN who received HCQ in addition to routine renin-angiotensin-aldosterone system inhibitors (RAASi) therapy were included. Ninety-two matched historical controls who received corticosteroids were selected by propensity score matching. The clinical data over 6?months were compared. RESULTS:Baseline proteinuria levels were comparable between the HCQ and corticosteroid groups (1.7 [1.2, 2.3] vs. 1.8 [1.3, 2.5] g/d, p?=?0.96). The percentage reduction in proteinuria at 6?months was smaller in the HCQ group than in the corticosteroid group (-?48.5% [-?62.6, -?31.4] vs. -62.9% [-?81.1, -?34.9], p?=?0.006). The time averaged proteinuria within the 6?months of observation was comparable for the HCQ and corticosteroid groups (1.1 [0.8, 1.5] vs. 1.1 [0.5, 1.8] g/d, p?=?0.48). The cumulative frequency of patients with a 50% reduction in proteinuria during the study was also comparable between the two groups (52.2% vs. 62.0%, p?=?0.25). However, six of the 92 (6.5%) patients suffered from severe adverse events (SAEs) in the corticosteroid group, while no SAEs were observed in the HCQ group (6.5% vs. 0%, p?=?0.03). CONCLUSIONS:The antiproteinuric effect of HCQ might be slightly inferior to that of corticosteroids over 6?months in patients with IgAN who were deemed to be candidates for HCQ and not corticosteroids treatment. However, HCQ treatment was safer than corticosteroid treatment.

SUBMITTER: Yang YZ 

PROVIDER: S-EPMC6683466 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature