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BMC Urology

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Open Access 01-12-2024 | Leflunomide | Research

Efficacy and safety of low-dose corticosteroids combined with leflunomide for progressive IgA nephropathy: a systematic review and meta-analysis

Authors: Dongxu Zhang, Bowen Xia, Xin Zhang, Pu Liang, Xiaopeng Hu

Published in: BMC Urology | Issue 1/2024

Abstract

Background and objective

The effectiveness of immunosuppressive and corticosteroid treatments for Immunoglobulin A (IgA) nephropathy (IgAN) remains thoroughly evaluated. We undertook a meta-analysis to investigate the efficacy and safety of low-dose corticosteroids plus leflunomide for progressive IgA nephropathy.

Methods

Eligible studies were obtained from PubMed, Embase, and Cochrane Library databases. We also searched the references of the included studies. Our protocol followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Eligibility criteria were defined using a PICOS framework.

Results

Our study included three articles presenting 342 patient cases. Findings revealed that low-dose corticosteroids combined with the leflunomide group were effective in relieving urine protein excretion (UPE) [mean difference (MD) = -0.35, 95% confidence interval (CI): -0.41 to -0.30, P < 0.00001] compared with the full-dose corticosteroids group. Regarding serum creatinine (SCr), estimated glomerular filtration rate (eGFR), complete remission rate, and overall response rate, there was no difference between the groups (p > 0.05). Regarding safety, low-dose corticosteroids combined with leflunomide significantly reduced the risk of serious adverse events [odds ratio (OR): 0.11, 95% CI: 0.01 to 0.91, P = 0.04]. Besides, no significant differences were observed between the two groups in the incidence of respiratory infection, abnormal liver function, diarrhea, herpes zoster, alopecia, pruritus, insomnia, pneumonia, diabetes, and urinary tract infection (P > 0.05).

Conclusions

Low-dose corticosteroids combined with leflunomide are a safe and effective treatment for progressive IgA nephropathy.

Trial registration

The PROSPERO registration number is CRD42022361883.

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Title: Efficacy and safety of low-dose corticosteroids combined with leflunomide for progressive IgA nephropathy: a systematic review and meta-analysis
Authors: Dongxu Zhang
Bowen Xia
Xin Zhang
Pu Liang
Xiaopeng Hu
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Leflunomide
Shingles
Alopecia
Published in: BMC Urology / Issue 1/2024
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-024-01438-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy and safety of low-dose corticosteroids combined with leflunomide for progressive IgA nephropathy: a systematic review and meta-analysis

Abstract

Background and objective

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and objective

Methods

Results

Conclusions

Trial registration

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