Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Jauhal, Arenn, Prasad, Bhanu, Rousseau-Gagnon, Mathieu, Ouellet, Gabriel, A Hladunewich, Michelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
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
_version_ 1784630066869698560
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
work_keys_str_mv AT jauhalarenn syntheticacthfortreatmentofglomerulardiseasesacaseseries
AT prasadbhanu syntheticacthfortreatmentofglomerulardiseasesacaseseries
AT rousseaugagnonmathieu syntheticacthfortreatmentofglomerulardiseasesacaseseries
AT ouelletgabriel syntheticacthfortreatmentofglomerulardiseasesacaseseries
AT ahladunewichmichelle syntheticacthfortreatmentofglomerulardiseasesacaseseries