Table 3.

Treatment regimens, data pre- and post-adrenocorticotropic hormone, and outcome category for patients with FSGS treated with adrenocorticotropic hormone

PatientTreatment RegimenIMD during ACTH TherapyDuration of ACTH Therapy (wk)Change in Laboratory Values before/after ACTH TreatmentOutcome
VariableInitialFinal
Columbia patients
 1ColumbiaTacrolimus, mycophenolic acida,b15Scr (mg/dl)2.73.7Failed
Proteinuria (mg/g)70002841
Albumin (g/dl)3.73.7
 2ColumbiaNone24Scr (mg/dl)2.31.3Partial
Proteinuria (mg/g)5046963
Albumin (g/dl)2.13.4
 3IndividualTacrolimus36Scr (mg/dl)1.10.7Partial
Proteinuria (mg/g)52001500
Albumin (g/dl)1.93.4
 4ColumbiaNone24Scr (mg/dl)1.21.4Complete
Proteinuria (mg/g)2100272
Albumin (g/dl)3.74.0
 5IndividualCyclosporine34Scr (mg/dl)2.61.1Failed
Proteinuria (mg/g)11,2007789
Albumin (g/dl)1.32.3
 6ColumbiaNone12Scr (mg/dl)3.22.9Failed
Proteinuria (mg/g)16,80025,000
Albumin (g/dl)1.61.4
 7IndividualNone56Scr (mg/dl)1.61.2Failed
Proteinuria (mg/g)10,3005380
Albumin (g/dl)2.03.3
 8ColumbiaNone28Scr (mg/dl)2.31.7Failed
Proteinuria (mg/g)23005620
Albumin (g/dl)2.93.6
 9ColumbiaNone23Scr (mg/dl)1.01.0Failed
Proteinuria (mg/g)16001900
Albumin (g/dl)3.63.8
 10ColumbiaCyclosporine19Scr (mg/dl)0.80.9Failed
Proteinuria (mg/g)22003847
Albumin (g/dl)2.92.4
 11IndividualMMF36Scr (mg/dl)3.41.5Failed
Proteinuria (mg/g)88009500
Albumin (g/dl)2.31.6
 12IndividualNoneb36Scr (mg/dl)3.61.3Partial
Proteinuria (mg/g)15,200891
Albumin (g/dl)2.13.4
Stanford patients
 13StanfordNone16Scr (mg/dl)2.22.2Failed
Proteinuria (mg/g)20201620
Albumin (g/dl)3.83.9
 14StanfordNone16Scr (mg/dl)2.72.9Failed
Proteinuria (mg/g)31702240
Albumin (g/dl)2.9NA
 15StanfordNone16Scr (mg/dl)1.01.1Partial
Proteinuria (mg/g)72401940
Albumin (g/dl)NA3.3
 16StanfordNone16Scr (mg/dl)3.02.7Failed
Proteinuria (mg/g)22002240
Albumin (g/dl)4.8NA
 17StanfordNone16Scr (mg/dl)2.22.1Failed
Proteinuria (mg/g)35504580
Albumin (g/dl)4.33.6
 18StanfordNone16Scr (mg/dl)3.33.9Failed
Proteinuria (mg/g)23,80018,600
Albumin (g/dl)1.72.8
 19StanfordNone16Scr (mg/dl)0.6NALost to follow-up
Proteinuria (mg/g)4860NA
Albumin (g/dl)2.4NA
 20StanfordNone16Scr (mg/dl)1.11.1Failed
Proteinuria (mg/g)23201570
Albumin (g/dl)3.43.8
 21StanfordNone16Scr (mg/dl)1.72.0Failed
Proteinuria (mg/g)17103230
Albumin (g/dl)3.23.9
 22StanfordNone16Scr (mg/dl)0.60.7Complete
Proteinuria (mg/g)4330270
Albumin (g/dl)1.73.6
 23StanfordNone16Scr (mg/dl)1.11.2Partial
Proteinuria (mg/g)65602120
Albumin (g/dl)2.22.1
 24StanfordNone16Scr (mg/dl)1.01.7Failed
Proteinuria (mg/g)20006100
Albumin (g/dl)3.3NA
  • Patient 19 was lost to follow-up. Columbia protocol: 80 units subcutaneously (SC) twice weekly for 24 weeks. Stanford protocol: 40 units subcutaneously weekly for 2 weeks, 80 units SC weekly for 2 weeks, then 80 units SC twice weekly to complete 16 weeks of therapy. Individual treatment regimens: Patient 3: 80 units twice weekly for 18 weeks, then 80 units weekly for 18 weeks; patient 5: 80 units twice weekly for 16 weeks, then three times weekly for 18 weeks; patient 7: 80 units twice weekly for 24 weeks, then 50 units twice weekly for 10 weeks, then 50–80 units weekly for 22 weeks; patient 11: 80 units twice weekly for 20 weeks, then 40 units twice weekly for 16 weeks; patient 12: 80 units twice weekly for 13 weeks, then 80 units weekly for 21 weeks. IMD, immunosuppressive drugs; ACTH, adrenocorticotropic hormone; Scr, serum creatinine, MMF, mycophenolate mofetil; NA, not applicable.

  • a Patient 1 had undergone four prior renal transplants for recurrent FSGS and was diagnosed with another recurrence 2 months before starting ACTH.

  • b Patient 1 underwent plasma exchange therapy; patient 12 completed plasma exchange therapy during week 1 of ACTH therapy.