Table 2 Key publications regarding the efficacy of immunosuppressive drugs in treating fibrillary glomerulonephritis
Treatment | Response | Authors |
|---|---|---|
Methyprednisolone/Prednisolone | No response | Asaba et al., 2003 |
Prednisolone & Mycophenolate mofetil | Persistent haematuria and proteinuria, improvement in serum creatinine levels | Bijol et al., 2006 |
Prednisolone, Cyclophosphamide then Cyclosporin | Brief initial response with prednisolone then relapse. No response with cyclophosphamide resolution of nephrotic syndrome with cyclosporin | Bircan et al., 2004 |
Prednisolone & Cyclophosphamide | Marked improvement in renal function | Blume et al., 2002 |
Corticosteroids +/- Cyclophosphamide | No response in fibrillary glomerulonephritis. Variable response in immunotactoid glomerulopathy including melphalan, vincristine, doxorubicin, carmustine or chlorambucil in various combinations, remission or improvement in nephrotic syndrome in 10/12 patients, disappearance of deposits from the kidneys of 2 patients | Bridoux et al., 2002 |
Prednisolone & Cyclophosphamide then Azathioprine | Transient reduction in proteinuria | Chan han, 1998 |
Prednisolone | Resolution of nephrotic syndrome or reduction in proteinuria | Dickenmann et al., 2002 |
Prednisolone & Chlorambucil | Slight reduction in creatinine, reduction in proteinuria from 3 g to 1 g in 24 h. | Dussol et al., 1998 |
Prednisolone | No response | Gielen et al., 2006 |
Prednisolone & Cyclophosphamide then Azathioprine | No response | Hsu et al., 2001 |
Prednisolone & Cyclophosphamide | Recovery of renal function, discontinuation of dialysis | Mahajan et al., 2005 |
Prednisolone | Improvement in renal function, reduction in proteinuria | Moriyama et al., 2003 |
Prednisolone & Chloraminophen (Chlorambucil) | Reduction in creatinine levels, disappearance of proteinuria and haematuria | Nabarra et al., 2003 |
Prednisolone & Mycophenolate mofetil | Continued rapid deterioration in renal function | Ovuworie et al., 2000 |
Prednisolone, Cyclophosphamide, plasmapheresis & immunoglobulins | Fibrils in renal transplant patient, continued rapid deterioration in renal function | Palanichamy et al., 1998 |
Various combinations of Cyclosporin A | Biopsy proven recurrence of fibrillary glomerulopathy in 3 transplanted kidneys | Pronovost et al., 1996 |
Prednisolone, Azathioprine and ATG (in 1 patient) | Rate of decline in renal allografts slower than native kidneys suggesting either benefit of immunosuppressive therapy or spontaneous remission with time | |
20 treated patients out of 56 | No effect of immunosuppression on incidence of or time to end stage renal disease | Rosenstock et al., 2003 |
Steroids alone (16% of patients) | Variable response including improvement in renal function and reduction in proteinuria | |
Cyclophosphamide +/- steroids (14%) Cyclosporin (5%) | Poor response of patients with immunotactoid glomerulopathy to immunosuppression except one good responder to fludarabine with improvement in renal function and reduced proteinuria | |
Prednisolone & Cyclophosphamide | Recovery of renal function, discontinuation of dialysis, recovery from pulmonary haemorrhage | Rovin et al., 1993 |
Prednisolone & Chlorambucil | Reduction or stabilization in creatinine levels, reduction in proteinuria | Schneider et al., 1996 |