Treatment preferences for primary membranous nephropathy: Results of a multinational survey among nephrologists in the South Asia Pacific region.
Anticoagulants
/ therapeutic use
Australasia
/ epidemiology
Calcineurin Inhibitors
/ therapeutic use
Chemoprevention
/ methods
Consensus
Cyclophosphamide
/ therapeutic use
Glomerulonephritis, Membranous
/ drug therapy
Humans
Immunosuppressive Agents
/ therapeutic use
Methylprednisolone
/ therapeutic use
Nephrologists
/ statistics & numerical data
Practice Patterns, Physicians'
/ statistics & numerical data
Surveys and Questionnaires
cyclophosphamide
cyclosporine
membranous nephropathy
rituximab
survey
Journal
Nephrology (Carlton, Vic.)
ISSN: 1440-1797
Titre abrégé: Nephrology (Carlton)
Pays: Australia
ID NLM: 9615568
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
revised:
02
07
2021
received:
20
05
2021
accepted:
14
07
2021
pubmed:
16
8
2021
medline:
8
3
2022
entrez:
15
8
2021
Statut:
ppublish
Résumé
There is no clear consensus on how best to treat primary membranous nephropathy (PMN). This study aimed to ascertain prevailing views among nephrologists on their choice of immunosuppressive agents to treat this disease. The Australasian Kidney Trials Network conducted a multinational online survey among nephrologists from the South Asia-Pacific region to identify prescribing practices to treat PMN. Survey questions focused on the types of immunosuppressive therapies used, preferred first-line and second-line therapies, indications for starting immunosuppressive therapy, the preferred mode of combining corticosteroid and cyclophosphamide, the use of serum phospholipase A2 receptor antibody testing in clinical practice, indications for anticoagulation, and interest in participating in future clinical trials in PMN. One hundered fifty-five nephrologists from eight countries responded to the online survey. The majority of them were senior nephrologists from Australia and India with significant experience managing patients with PMN. The combination of cyclophosphamide and corticosteroid was the preferred first-line therapy. Of those who used this combination, only 34.8% followed the Kidney Disease Improving Global Outcomes (KDIGO) 2012 guidelines by adding intravenous methylprednisolone. The combination of calcineurin inhibitor with corticosteroid was the most common second-line therapy. Most respondents considered prophylactic anticoagulation if serum albumin was less than 25 g/L. Most nephrologists were keen to participate in a clinical trial with a control arm consisting of cyclophosphamide and corticosteroids. The combination of corticosteroid with cyclophosphamide (without intravenous methylprednisolone) is the most commonly reported first-line immunosuppressive therapy for the management of PMN.
Substances chimiques
Anticoagulants
0
Calcineurin Inhibitors
0
Immunosuppressive Agents
0
Cyclophosphamide
8N3DW7272P
Methylprednisolone
X4W7ZR7023
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-43Informations de copyright
© 2021 Asian Pacific Society of Nephrology.
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