Clinical Efficacy And Safety Of Full-dose Versus Half-dose Corticosteroids Plus Leflunomide For IgA Nephropath

Background:The results of leflunomide(LEF)in patients with IgA nephropathy(IgAN)were inconsistent.Methods:A total of 149 kidney biopsy-confirmed IgAN patients with an estimated glomerular filtration rate(eGFR)≥50 ml/min/1.73 m2 and protein excretion levels≥0.75 g/d were enrolled,with 65 subjects receiving half-dose CS plus LEF(LEF group),and the 84 counterpart patients accepting full-dose corticosteroid(Full CS group).The primary outcomes included the complete remission(CR)rates and incidence of adverse events(AEs).The secondary outcomes were the overall remission(OR)rates and a combined event(eGFR reduced≥30%,end-stage renal disease[ESRD],hemodialysis,peritoneal dialysis,or kidney transplantation).Results:During the 18 months of follow-up,the CR rates were 72 and 64%in the LEF and Full CS groups(P=0.299),respectively.The proportion of patients with OR rates in the LEF group and Full CS group was 89%versus 75%,respectively(P=0.027).Serious AEs were observed only in the Full CS group(P=0.017).The incidences of total AEs(P=0.036)and infections(P=0.024)were lower in the LEF group than in the Full CS group.Conclusions:LEF combined with half-dose CS is superior to full-dose CS in the treatment of IgAN.