Evidence map›Paper›PMID 30965344›Full record

Trial reportAmerican journal of nephrology2019

Open-Label Clinical Trials of Oral Pulse Dexamethasone for Adults with Idiopathic Nephrotic Syndrome.

Monique E Cho, Mary H Branton, David A Smith, Linda Bartlett, Lilian Howard, James C Reynolds, Donald Rosenstein, Sanjeev Sethi, M Berenice Nava, Laura Barisoni and 2 more

Open access · bronzeAbstract readClinical Trial, Phase IIRandomized Controlled Trial
In one paragraph

Trial report in American journal of nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Interventions for focal segmental glomerulosclerosis in adults.The Cochrane database of systematic reviews · 2022
    Pooled it
  2. Role of the glucocorticoid receptor in glomerular disease.American journal of physiology. Renal physiology · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Monique E ChoKidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland, USA.
Mary H BrantonKidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland, USA.
David A SmithKidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland, USA.
Linda BartlettKidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland, USA.
Lilian HowardKidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland, USA.
James C ReynoldsRadiology and Imaging Services, Mark O. Hatfield Clinical Research Center, Bethesda, Maryland, USA.
Donald RosensteinDepartment of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA.
Sanjeev SethiDepartment of Pathology, Mayo Clinic, Rochester, Minnesota, USA.
M Berenice NavaKidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland, USA.
Laura BarisoniDepartment of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Fernando C FervenzaDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Jeffrey B KoppKidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland, USA, jbkopp@NIH.gov.
National Institute of Diabetes and Digestive and Kidney Diseases · USMayo Clinic · USOffice of Research Services · USUniversity of Miami · USUniversity of North Carolina at Chapel Hill · US

Funding

Focal segmental glomerulosclerosis: TreatmentZIADK043412 · NIDDK · NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES · PI KOPP, JEFFREY BURNETT · 2009 to 2024
$7.4M
Focal segmental glomerulosclerosis: TreatmentZ01DK043412 · NIDDK · NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES · PI KOPP, JEFFREY BURNETT · 2007 to 2008
$989k
Intramural NIH HHS Z01 DK043412
6 · The paper itself

Abstract

backgroundIn adults with primary focal segmental glomerulosclerosis (FSGS), daily prednisone may induce complete remissions (CR) and partial remissions (PR), but relapses are frequent and adverse events are common.

methodsWe carried out 2 open-label, uncontrolled trials to explore the efficacy and tolerability of pulse oral dexamethasone as an alternative to daily prednisone. We enrolled adult patients with proteinuria > 3.5 g/day despite the use of renin-angiotensin-aldosterone blockade. In the first trial, we enrolled 14 subjects with FSGS and administered 4 dexamethasone doses (25 mg/m2) daily for 4 days, repeated every 28 days over 32 weeks. The second trial involved a more intensive regimen. Eight subjects received 4 dexamethasone doses of 50 mg/m2 every 4 weeks for 12 weeks, followed by 4 doses of 25 mg/m2 every 4 weeks for 36 weeks; subjects were randomized to 2 doses every 2 weeks or 4 doses every 4 weeks.

resultsIn the first trial, we enrolled 13 subjects with FSGS and 1 with minimal change disease and found a combined CR and PR rate of 36%. In the second trial, we enrolled 8 subjects. The combined CR and PR rate was 29%. Analysis combining both trials showed a combined CR and PR rate of 33%. Adverse events were observed in 32% of subjects, with mood symptoms being most common. There were no serious adverse events related to the study.

conclusionWe conclude that high dose oral dexamethasone is well tolerated by adults with idiopathic nephrotic syndrome and may have some efficacy.

Indexed as

Administration, OralAdultAgedDexamethasoneFemaleFollow-Up StudiesGlomerulosclerosis, Focal SegmentalHumansImmunosuppressive AgentsMaleMiddle AgedNephrotic SyndromePulse Therapy, DrugRemission InductionYoung AdultDexamethasoneImmunosuppressive AgentsGlucocorticoidsProteinuriaRemissionSteroids

Identifiers

PMID30965344
PMCPMC6677391
OpenAlexW2935977617

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.