Evidence map›Paper›PMID 31385176›Full record

ArticleInternational urology and nephrology2019

Evaluation of low-dose glucocorticoid regimen in association with cyclophosphamide in patients with glomerulonephritis.

Anca Roxana Hirja, Luminita Voroneanu, Dimitrie Siriopol, Ionut Nistor, Simona Hogas, Mugurel Apetrii, Carmen Volovat, Gabriel Veisa, Irina Luanda Mititiuc, Laura Florea and 2 more

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In one paragraph

Article in International urology and nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 30% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

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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 1 institution in 1 country.

Anca Roxana HirjaNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania. anca.hirja@gmail.com.
Luminita VoroneanuNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Dimitrie SiriopolNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Ionut NistorNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Simona HogasNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Mugurel ApetriiNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Carmen VolovatNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Gabriel VeisaNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Irina Luanda MititiucNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Laura FloreaNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Mihai OnofriescuNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Adrian CovicNephrology Department, "Grigore T. Popa" University of Medicine and Pharmacy, University Street, No. 16, 700115, Iasi, Romania.
Grigore T. Popa University of Medicine and Pharmacy · RO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe treatment of most glomerulonephritides is still based on a combination of an oral corticosteroid and an alkylating agent, with favorable outcomes, but with serious side effects. The objective of this study was to reduce the cumulative corticosteroid dose in patients with high risk of corticosteroid-related adverse events by replacing daily oral corticosteroids with intravenous (iv) methylprednisolone pulses, associated with monthly pulse i.v. cyclophosphamide (according to KDIGO guidelines) in patients with glomerulonephritis.

methodsThis was a retrospective cohort study conducted at a single nephrology centre. In the course of a 6-month run-in phase, all the patients received non-immunosuppressive pathogenic treatment. High-risk patients, who still had urinary protein excretion of at least 3.5 g per day at the end of these 6 months, received a combination of corticosteroids and cyclophosphamide. Patients were divided in two groups: group 1 (23 patients)-included patients with high risk of corticosteroid-related adverse events received monthly methylprednisolone 1 g/day, 3 days and i.v. cyclophosphamide for 6 months, and group 2 (84 patients)-received oral corticosteroids (as per KDIGO recommended dose) and i.v. cyclophosphamide. The primary outcome-time to a combined end-point of doubling of serum creatinine, ESRD, need for chronic renal replacement therapy or death; secondary outcomes: complete remission [proteinuria < 0.3 g per 24 h (urinary protein-creatinine rate < 300 mg/g [< 30 mg/mmol]]; partial remission (proteinuria > 0.3 but < 3.5 g per 24 h or a decrease in proteinuria by at least 50% from the initial value) and adverse events.

resultsAt 6 months, there was no difference in the primary composite end-point: 8.7% patients from the group 1 and 20.2% patients from the group 2 (P = 0.199) reached this end-point. Similar data were also recorded at 12 months. Secondary end-points were also similar between treatment groups. More patients receiving oral corticosteroids experienced infections, but without statistical significance.

conclusionOur data indicate that low i.v. dose corticosteroids and cyclophosphamide administered monthly in patients with high risk of corticosteroid-related adverse events and primary glomerulonephritis are equally effective, with fewer metabolic disorders and infections.

Indexed as

Administration, IntravenousAdultCohort StudiesCyclophosphamideDrug Therapy, CombinationFemaleGlomerulonephritisGlucocorticoidsHumansImmunosuppressive AgentsMaleMethylprednisoloneMiddle AgedRetrospective StudiesCyclophosphamideGlucocorticoidsImmunosuppressive AgentsMethylprednisoloneInfectionLow-dose corticosteroidsPrimary glomerulonephritisRemissionSide effects

Identifiers

PMID31385176
OpenAlexW2966622644

What OpenQuestion holds

Textmetadata
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.