Title:Drug Therapies for Patients with IgA Nephropathy: A Network Meta-analysis of Randomized Clinical Trials
VOLUME: 15 ISSUE: 2
Author(s):Kannan Sridharan* and Gowri Sivaramakrishnan
Affiliation:Department of Pharmacology & Therapeutics, College of Medicine and Medial Sciences, Arabian Gulf University, Manama, Dental Specialist (Prosthodontist), Dental Training Department, Ministry of Health, Manama
Keywords:Corticosteroids, immunosuppressants, angiotensin receptor blockers, angiotensin converting enzyme inhibitors,
renin inhibitors, hypolipidemics.
Abstract:Background: Several drugs are used for treating IgA nephropathy (IgAN). We carried
out a network meta-analysis evaluating these drugs.
Methods: Electronic databases were searched for appropriate randomized clinical trials carried out
in patients with IgAN. The primary outcome was proteinuria remission rates and there were several
other secondary outcome measures. The risk of bias was assessed. Mixed treatment comparison
estimates were modelled from direct and indirect comparison estimates. Grading of the evidence for
key comparisons was carried out.
Results: Fifty-seven clinical trials were included in the systematic review and 51 in the metaanalysis.
Polyunsaturated fatty acids, corticosteroids/angiotensin receptor blockers (ARB), ARB,
angiotensin converting enzyme inhibitors (ACEI), ARB/ACEI, corticosteroids/ACEI and hypolipidemics/
ARB were observed with significantly higher rates of proteinuria remission than the standard
of care. Several benefits were observed with other drugs on the secondary outcome measures.
A very low grade was observed for the interventions.
Conclusion: We observed a few interventions to perform better in the management of IgAN. The
results of this study will aid in further evaluation of such drugs that may assist in saving the resources
and time. However, the readers should interpret the findings with great caution as the results
might change with the advent of future head-to-head clinical trials.
