Trial reportPediatric nephrology (Berlin, Germany)2018
Combination therapy with or without warfarin and dipyridamole for severe childhood IgA nephropathy: an RCT.
Trial report in Pediatric nephrology (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- IPNA clinical practice recommendations for the diagnosis and management of children with IgA nephropathy and IgA vasculitis nephritis.Pediatric nephrology (Berlin, Germany) · 2025Guideline
- Clinical study outcomes in IgA nephropathy: A systematic literature review and narrative synthesis.PloS one · 2025Pooled it
- Immunosuppressive therapy for IgA nephropathy in children.The Cochrane database of systematic reviews · 2024Pooled it
- Non-immunosuppressive treatment for IgA nephropathy.The Cochrane database of systematic reviews · 2024Pooled it
- Immunosuppressive agents for treating IgA nephropathy.The Cochrane database of systematic reviews · 2020Pooled it
- Early detection of proteinuria to prevent kidney fibrosis and progression to kidney failure: lessons from the School Urine Screening Program in Japan.Pediatric nephrology (Berlin, Germany) · 2026Review
- Efficacy and safety of telitacicept in the treatment of pediatric IgA nephropathy: a retrospective study.Pediatric nephrology (Berlin, Germany) · 2026Observational
- IgA nephropathy: a novel pathway in immunopathogenesis dependent on the timing of Epstein-Barr virus infection.Frontiers in immunology · 2026Review
- Pharmacological interventions in IgA nephropathy: protocol for a living systematic review and network meta-analysis.BMJ open · 2025Article
- Cost-Effectiveness of School Urinary Screening for Early Detection of IgA Nephropathy in Japan.JAMA network open · 2024Article
- Long-term outcome of combination therapy with corticosteroids, mizoribine and RAS inhibitors as initial therapy for severe childhood IgA vasculitis with nephritis.Pediatric nephrology (Berlin, Germany) · 2023Article
- Corticosteroids in the treatment of IgA nephropathy: lessons from the TESTING trial.Pediatric nephrology (Berlin, Germany) · 2023Review
- Plasma D-dimer as a potential predictor of progression in IgA nephropathy: a cohort study.Renal failure · 2023Article
- Efficacy of combination therapy for childhood complicated focal IgA nephropathy.Clinical and experimental nephrology · 2022Article
- Treatment strategy with multidrug therapy and tonsillectomy pulse therapy for childhood-onset severe IgA nephropathy.Clinical and experimental nephrology · 2022Review
- Assessing Patient Preferences in Rare Diseases: Direct Preference Elicitation in the Rare Chronic Kidney Disease, Immunoglobulin A Nephropathy.The patient · 2021Article
- Non-immunosuppressive therapies for childhood IgA nephropathy.Pediatric nephrology (Berlin, Germany) · 2021Review
- Coagulation parameters are associated with the prognosis of immunoglobulin a nephropathy: a retrospective study.BMC nephrology · 2020Article
- Eculizumab for pediatric dense deposit disease: A case report and literature review.Clinical nephrology. Case studies · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTwo previous randomized controlled trials showed that treatment of severe childhood immunoglobulin A (IgA) nephropathy using prednisolone with azathioprine, heparin-warfarin, or dipyridamole prevented the increase of sclerosed glomeruli. Prednisolone alone, however, did not prevent further increase. These studies indicated the importance of immunosuppressants in the treatment. An additional pilot study using mizoribine instead of azathioprine enabled us to complete 2 years of combined regimen. It showed non-numerical inferior effectiveness compared with the azathioprine regimen. Further examination of the additional efficacy of warfarin and dipyridamole was required.
methodsA randomized control trial of prednisolone and mizoribine with (group 1) or without (group 2) warfarin and dipyridamole was administered for treatment of 71 children with severe IgA nephropathy to evaluate the efficacy of additional warfarin and dipyridamole.
resultsThirty of 34 patients (88.2%) in group 1, and 27 of 36 patients (75.0%) showed the disappearance of proteinuria as defined by early morning urinary protein to creatinine ratio of < 0.2 during the 2-year treatment period. The cumulative disappearance rate of proteinuria determined by the Kaplan-Meier method showed that the disappearance rate of proteinuria was significantly higher in group 1 than in group 2 (log-rank P = 0.04). There was no significant difference in pathological findings, but there was a tendency of increase of global sclerosis in group1 which might be related to warfarin. Most of the adverse effects were related to prednisolone, but fortunately transient.
conclusionsThe balance between minimal benefits of warfarin/dipyridamole and potential adverse effects may be in favor of avoiding them in children with IgA nephropathy.
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