Abstract:

Objective: A prospective randomized clinical trial was conducted to evaluate the efficacy and safety of modified methylprednisolone plus intravenous cyclophosphamide pulse therapy in Chinese patients with idiopathic membranous nephropathy (IMN). Methodology: Fifty-nine patients with biopsy-proven IMN and proteinuria > 3.5g/d were enrolled in this trial. They were randomized to be given methylprednisolone (0.5g intravenously for 3 consecutive days followed by oral predsine, 0.4mg/kg per d for 27d) alternated every other month with cyclophosphamide 0.75g/m2BSA intravenously (MP+CTX group) and Valsatan 160mg/d (control group). The whole treatment lasted 6 months. The efficacy and safety of this regimen was evaluated. Results: They were 29 cases in MP+CTX group and 31 cases in control group. The remission rate and complete remission rate were 31.0% and 27.6% in MP+CTX group, 0 and 9.7% in control group respectively after 6 months treatment. The serum creatinine was stable in two groups. No severe adverse events were observed during the course of treatment. Conclusion: A 6-month course of treatment with modified Ponticelli regimen was a useful and safe therapy to reduce proteinuria in Chinese patients with nephrotic IMN.

Key words:  , idiopathic membranous nephropathy, intravenous pulse cyclophosphamide, Chinese patients