Treatment regimens, data pre- and post-adrenocorticotropic hormone, and outcome category for patients with FSGS treated with adrenocorticotropic hormone
Patient | Treatment Regimen | IMD during ACTH Therapy | Duration of ACTH Therapy (wk) | Change in Laboratory Values before/after ACTH Treatment | Outcome | ||
---|---|---|---|---|---|---|---|
Variable | Initial | Final | |||||
Columbia patients | |||||||
1 | Columbia | Tacrolimus, mycophenolic acida,b | 15 | Scr (mg/dl) | 2.7 | 3.7 | Failed |
Proteinuria (mg/g) | 7000 | 2841 | |||||
Albumin (g/dl) | 3.7 | 3.7 | |||||
2 | Columbia | None | 24 | Scr (mg/dl) | 2.3 | 1.3 | Partial |
Proteinuria (mg/g) | 5046 | 963 | |||||
Albumin (g/dl) | 2.1 | 3.4 | |||||
3 | Individual | Tacrolimus | 36 | Scr (mg/dl) | 1.1 | 0.7 | Partial |
Proteinuria (mg/g) | 5200 | 1500 | |||||
Albumin (g/dl) | 1.9 | 3.4 | |||||
4 | Columbia | None | 24 | Scr (mg/dl) | 1.2 | 1.4 | Complete |
Proteinuria (mg/g) | 2100 | 272 | |||||
Albumin (g/dl) | 3.7 | 4.0 | |||||
5 | Individual | Cyclosporine | 34 | Scr (mg/dl) | 2.6 | 1.1 | Failed |
Proteinuria (mg/g) | 11,200 | 7789 | |||||
Albumin (g/dl) | 1.3 | 2.3 | |||||
6 | Columbia | None | 12 | Scr (mg/dl) | 3.2 | 2.9 | Failed |
Proteinuria (mg/g) | 16,800 | 25,000 | |||||
Albumin (g/dl) | 1.6 | 1.4 | |||||
7 | Individual | None | 56 | Scr (mg/dl) | 1.6 | 1.2 | Failed |
Proteinuria (mg/g) | 10,300 | 5380 | |||||
Albumin (g/dl) | 2.0 | 3.3 | |||||
8 | Columbia | None | 28 | Scr (mg/dl) | 2.3 | 1.7 | Failed |
Proteinuria (mg/g) | 2300 | 5620 | |||||
Albumin (g/dl) | 2.9 | 3.6 | |||||
9 | Columbia | None | 23 | Scr (mg/dl) | 1.0 | 1.0 | Failed |
Proteinuria (mg/g) | 1600 | 1900 | |||||
Albumin (g/dl) | 3.6 | 3.8 | |||||
10 | Columbia | Cyclosporine | 19 | Scr (mg/dl) | 0.8 | 0.9 | Failed |
Proteinuria (mg/g) | 2200 | 3847 | |||||
Albumin (g/dl) | 2.9 | 2.4 | |||||
11 | Individual | MMF | 36 | Scr (mg/dl) | 3.4 | 1.5 | Failed |
Proteinuria (mg/g) | 8800 | 9500 | |||||
Albumin (g/dl) | 2.3 | 1.6 | |||||
12 | Individual | Noneb | 36 | Scr (mg/dl) | 3.6 | 1.3 | Partial |
Proteinuria (mg/g) | 15,200 | 891 | |||||
Albumin (g/dl) | 2.1 | 3.4 | |||||
Stanford patients | |||||||
13 | Stanford | None | 16 | Scr (mg/dl) | 2.2 | 2.2 | Failed |
Proteinuria (mg/g) | 2020 | 1620 | |||||
Albumin (g/dl) | 3.8 | 3.9 | |||||
14 | Stanford | None | 16 | Scr (mg/dl) | 2.7 | 2.9 | Failed |
Proteinuria (mg/g) | 3170 | 2240 | |||||
Albumin (g/dl) | 2.9 | NA | |||||
15 | Stanford | None | 16 | Scr (mg/dl) | 1.0 | 1.1 | Partial |
Proteinuria (mg/g) | 7240 | 1940 | |||||
Albumin (g/dl) | NA | 3.3 | |||||
16 | Stanford | None | 16 | Scr (mg/dl) | 3.0 | 2.7 | Failed |
Proteinuria (mg/g) | 2200 | 2240 | |||||
Albumin (g/dl) | 4.8 | NA | |||||
17 | Stanford | None | 16 | Scr (mg/dl) | 2.2 | 2.1 | Failed |
Proteinuria (mg/g) | 3550 | 4580 | |||||
Albumin (g/dl) | 4.3 | 3.6 | |||||
18 | Stanford | None | 16 | Scr (mg/dl) | 3.3 | 3.9 | Failed |
Proteinuria (mg/g) | 23,800 | 18,600 | |||||
Albumin (g/dl) | 1.7 | 2.8 | |||||
19 | Stanford | None | 16 | Scr (mg/dl) | 0.6 | NA | Lost to follow-up |
Proteinuria (mg/g) | 4860 | NA | |||||
Albumin (g/dl) | 2.4 | NA | |||||
20 | Stanford | None | 16 | Scr (mg/dl) | 1.1 | 1.1 | Failed |
Proteinuria (mg/g) | 2320 | 1570 | |||||
Albumin (g/dl) | 3.4 | 3.8 | |||||
21 | Stanford | None | 16 | Scr (mg/dl) | 1.7 | 2.0 | Failed |
Proteinuria (mg/g) | 1710 | 3230 | |||||
Albumin (g/dl) | 3.2 | 3.9 | |||||
22 | Stanford | None | 16 | Scr (mg/dl) | 0.6 | 0.7 | Complete |
Proteinuria (mg/g) | 4330 | 270 | |||||
Albumin (g/dl) | 1.7 | 3.6 | |||||
23 | Stanford | None | 16 | Scr (mg/dl) | 1.1 | 1.2 | Partial |
Proteinuria (mg/g) | 6560 | 2120 | |||||
Albumin (g/dl) | 2.2 | 2.1 | |||||
24 | Stanford | None | 16 | Scr (mg/dl) | 1.0 | 1.7 | Failed |
Proteinuria (mg/g) | 2000 | 6100 | |||||
Albumin (g/dl) | 3.3 | NA |
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.