Current and emerging treatments for idiopathic focal and segmental glomerulosclerosis in adults

Figures & data

Table 1. Results of observational studies that used prolonged glucocorticoid administration in adults with focal and segmental glomerular sclerosis and nephrotic syndrome.

Study (year)	Patients (n)	Complete remission (n)	Mean duration (months)	Ref.
Pei et al. (1987)	18	7 (39%)	6	[25]
Agarwal et al. (1993)	38	12 (32%)	6	[26]
Ponticelli et al. (1999)	53	21 (40%)	6	[17]
Chun et al. (2004)	87	29 (33%)	4–6	[27]
Total	196	69 (35%)

Table 2. Prevention of glucocorticoid-induced osteoporosis in postmenopausal women and men older than 50 years.

Risk stratification of glucorticoid osteoporosis	Dosage regimen
Low risk	If prednisone <7.5 mg/day, no pharmacological treatment is needed
	If prednisone >7.5 mg/day, alendronate risedronate or zoledronic acid
Medium risk	If glucocorticoids are given for >3 months, alendronate isedronate or zoledronic acid irrespective of the doses of glucocorticoids
High risk	If glucocorticoids are given for >1 month, alendronate isedronate or zoledronic acid irrespective of the doses of glucocorticoids

Risk stratification is based on low BMI, smoking, parental history of hip fractures, higher alcoholic drinks per day, daily and cumulative glucocorticoid dose.

Adapted from recommendations of the American College of Rheumatology [32].

Table 3. Results with cyclosporine in adults with idiopathic focal and segmental glomerular sclerosis resistant to steroids.

Study (year)	Patients (n)	Complete remission (n)	Partial remission (n)	Ref.
Maher et al. (1988)	4	0	0	[35]
Zietse et al. (1992)	4	0	0	[36]
Meyrier (2004)	123	17	15	[37]
Lee et al. (1995)	5	2	2	[38]
Heering et al. (2004)	34	8	13	[39]
Alexopoulos et al. (2000)	11	3	6	[40]
Total	181	30 (17%)	36 (20%)

Table 4. Results of observational studies with tacrolimus in adults with idiopathic focal segmental glomerular sclerosis.

Study (year)	Patients (n)	Complete remission (n)	Partial remission (n)	Ref.
McCauley et al. (1993)	4		3	[44]
Segarra et al. (2002)	25	10	3	[45]
Duncan et al. (2004)	6		6	[46]
Li et al. (2009)	7	2	2	[47]
Total	42	12 (29%)	14 (33%)

Table 5. Results of observational studies with mycophenolate mofetil in adults with idiopathic focal and segmental glomerular sclerosis.

Study (year)	Patients (n)	Complete remission	Partial remission	Ref.
Choi et al. (2002)	9	1	4	[54]
Cattran et al. (2004)	18	1	7	[55]
Tang et al. (2005)	16	5	1	[56]
Senthil Nayagam et al. (2008)	34	8	13	[57]
Segarra Medrano et al. (2011)	27		4	[58]
Total	72	8 (11%)	16 (22%)

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