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Synthetic ACTH for Treatment of Glomerular Diseases: A Case Series
RATIONALE: Synthetic adrenocorticotropic hormone (Tetracosactide) has been used in the treatment of refractory glomerular diseases. Literature surrounding the use of this medication is limited to small case series and there is conflicting data on the rate of adverse events associated with this medic...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744192/ https://www.ncbi.nlm.nih.gov/pubmed/35024153 http://dx.doi.org/10.1177/20543581211066979 |
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author | Jauhal, Arenn Prasad, Bhanu Rousseau-Gagnon, Mathieu Ouellet, Gabriel A Hladunewich, Michelle |
author_facet | Jauhal, Arenn Prasad, Bhanu Rousseau-Gagnon, Mathieu Ouellet, Gabriel A Hladunewich, Michelle |
author_sort | Jauhal, Arenn |
collection | PubMed |
description | RATIONALE: Synthetic adrenocorticotropic hormone (Tetracosactide) has been used in the treatment of refractory glomerular diseases. Literature surrounding the use of this medication is limited to small case series and there is conflicting data on the rate of adverse events associated with this medication. PRESENTING CONCERNS OF THE PATIENT: Glomerulonephritis not in remission after at least 6 months of treatment with conservative care. Stable doses of concurrent immunosuppression were permitted. DIAGNOSES: Membranous nephropathy, IgA nephropathy, minimal change disease, and focal and segmental glomerulosclerosis. INTERVENTION: Intramuscular synthetic adrenocorticotropic hormone (Tetracosactide, Synacthen Depot) with doses of either 1 mg weekly or 1 mg twice weekly. OUTCOMES: Five of 12 patients had at least a partial remission with Tetracosactide. Median time to response was 6 months for responders. Five of the 12 patients had adverse events documented, 2 of which led to treatment discontinuation. No patients with focal and segmental glomerulosclerosis responded to treatment. LESSONS LEARNED: Higher rate of adverse events than previously reported with synthetic adrenocorticotropic hormone and uncertain treatment efficacy. |
format | Online Article Text |
id | pubmed-8744192 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-87441922022-01-11 Synthetic ACTH for Treatment of Glomerular Diseases: A Case Series Jauhal, Arenn Prasad, Bhanu Rousseau-Gagnon, Mathieu Ouellet, Gabriel A Hladunewich, Michelle Can J Kidney Health Dis Educational Case Report RATIONALE: Synthetic adrenocorticotropic hormone (Tetracosactide) has been used in the treatment of refractory glomerular diseases. Literature surrounding the use of this medication is limited to small case series and there is conflicting data on the rate of adverse events associated with this medication. PRESENTING CONCERNS OF THE PATIENT: Glomerulonephritis not in remission after at least 6 months of treatment with conservative care. Stable doses of concurrent immunosuppression were permitted. DIAGNOSES: Membranous nephropathy, IgA nephropathy, minimal change disease, and focal and segmental glomerulosclerosis. INTERVENTION: Intramuscular synthetic adrenocorticotropic hormone (Tetracosactide, Synacthen Depot) with doses of either 1 mg weekly or 1 mg twice weekly. OUTCOMES: Five of 12 patients had at least a partial remission with Tetracosactide. Median time to response was 6 months for responders. Five of the 12 patients had adverse events documented, 2 of which led to treatment discontinuation. No patients with focal and segmental glomerulosclerosis responded to treatment. LESSONS LEARNED: Higher rate of adverse events than previously reported with synthetic adrenocorticotropic hormone and uncertain treatment efficacy. SAGE Publications 2022-01-05 /pmc/articles/PMC8744192/ /pubmed/35024153 http://dx.doi.org/10.1177/20543581211066979 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Educational Case Report Jauhal, Arenn Prasad, Bhanu Rousseau-Gagnon, Mathieu Ouellet, Gabriel A Hladunewich, Michelle Synthetic ACTH for Treatment of Glomerular Diseases: A Case Series |
title | Synthetic ACTH for Treatment of Glomerular Diseases: A Case
Series |
title_full | Synthetic ACTH for Treatment of Glomerular Diseases: A Case
Series |
title_fullStr | Synthetic ACTH for Treatment of Glomerular Diseases: A Case
Series |
title_full_unstemmed | Synthetic ACTH for Treatment of Glomerular Diseases: A Case
Series |
title_short | Synthetic ACTH for Treatment of Glomerular Diseases: A Case
Series |
title_sort | synthetic acth for treatment of glomerular diseases: a case
series |
topic | Educational Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744192/ https://www.ncbi.nlm.nih.gov/pubmed/35024153 http://dx.doi.org/10.1177/20543581211066979 |
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