A randomized controlled trial of prednisone in patients with idiopathic membranous nephropathy

Article Abstract:

Idiopathic membranous nephropathy (membranous glomerulonephritis) is a chronic disease causing inflammation of the blood vessels in the glomeruli (filtering system) of the kidney. It is characterized by edema, protein and blood in the urine, high blood pressure and kidney failure. Prednisone, an anti-inflammatory drug, has been the treatment of choice for patients with idiopathic membranous nephropathy for many years. A long term study analyzes the benefits of prednisone therapy in 158 patients who were given prednisone every other day for six months and followed-up for an average of four years. A similar group of patients was given a placebo. In some patients who received prednisone blood creatinine clearance levels decreased (an indicator of improving kidney function), but they were not significantly different from the levels in the placebo group. Reduction of protein in the urine and recovery of kidney function did not differ between the two groups. Due to the lack of clinical improvement and the fact that prednisone has potentially serious side-effects it is suggested that prednisone is of no benefit to patients diagnosed with idiopathic membranous nephropathy.

Prevention, Chronic kidney failure

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What have we learned about the treatment of idiopathic membranous nephropathy with steroids?

Article Abstract:

Idiopathic membranous nephropathy (membranous glomerulonephritis) causes inflammation of the blood vessels in the glomeruli (filtering system) of the kidney. It is characterized by swelling, protein and blood in the urine, high blood pressure and kidney failure. Prednisone, an anti-inflammatory steroid drug, has been the treatment of choice for patients with idiopathic membranous nephropathy for many years. Nephrotic syndrome (destruction of kidney cells) develops in 5 percent of these patients; 25 percent of untreated patients go into spontaneous complete remission. The effectiveness of steroid therapy was studied and it is reported that there was no added benefit to patients who received prednisone. The difference in the results of this research may be explained by the combinations of drugs used by other investigators and the more seriously ill populations of patients who participated in previous studies. After these factors are taken into consideration it may be concluded that steroid therapy should be started earlier rather than later in patients with idiopathic membranous nephropathy. This issue should be resolved with further investigation.

Evaluation, Drugs, Testing, editorial

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Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer

Article Abstract:

Docetaxel plus estramustine improves survival over that afforded by mitoxantrone plus prednisone in men with androgen-independent prostate cancer. Treatment with estramustine and docetaxel increases survival at the cost of an increased rate of adverse events.

England, Prostate cancer, Nitrogen mustards, Estramustine

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