EFFICACY AND SAFETY OF BUDESONIDE IN IGA NEPHROPATHY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

E-Poster

https://storage.unitedwebnetwork.com/files/1099/dbd3405a07bb146cee4209ce9e7bb7e9.pdf

Abstract Title

First Name *

João Lucas

Last Name *

de Magalhães Leal Moreira

Co-author 1

Elísio Santos Bulhões Júnior elisiosantos271@gmail.com Faculdade de Ensino Superior da Amazônia Reunida Department medicine Redenção

Co-author 2

Vânio Antunes do Livramento Junior vanio.antunes.md@gmail.com Universidade Federal de Ciências da Saúde de Porto Alegre Medicina Porto Alegre

Co-author 3

Beatriz Araújo beatriz.araujo12@outlook.com Universidade Nove de Julho Departamento de Medicina São Bernardo do Campo

Co-author 4

Giovanna Veiga Gomes veigagomesgiovanna@gmail.com Universidade Municipal de São Caetano do Sul Departamento de Medicina São Caetano do Sul

Co-author 5

Vitor Expedito Alves Ribeiro vitorexpedito020@gmail.com Universidade Federal do Piauí Centro de Ciências da Saúde Teresina

Co-author 6

Roberto Augusto Mazetto Silva Vieira ramsv.med21@uea.edu.br Universidade do Estado do Amazonas Escola Superior de Ciências da Saúde (ESA-UEA) Manaus

Co-author 7

Esther Patricia de Souza Borges estherpatriciaepc@gmail.com Universidade Federal da Grande Dourados Faculdade de Ciências da Saúde (FCS) Dourados

Co-author 8

Erika Bião Lima Oliveira Sampaio eblosampaio@uefs.br Universidade Estadual de Feira de Santana Departamento de Saúde Feira de Santana

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

IgA nephropathy is one of the most common causes of glomerulopathy worldwide. However, the efficacy and safety of budesonide in the treatment of IgA nephropathy remains uncertain.

Methods

We systematically searched PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov databases for randomized controlled trials (RCTs) comparing budesonide with conservative therapy in patients with IgA nephropathy. Data were extracted from published reports and quality assessment was performed on the recommendations from Cochrane. Our outcomes of interest were: (1) increase eGFR, (2) microhematuria, (3) adverse events and (4) dyspepsia. Mean differences (MD) and risk ratios (RR) were pooled with the corresponding 95% confidence intervals (CI). Heterogeneity was examined with I² statistics. R Version 4.3.1 was used for statistical analysis.

Results

We included three RCTs comprising 566 patients, of whom 257 (45.4%) were randomized to receive budesonide therapy, 252 (44.5%) patients were male, and the mean age was 37.9 (range, 21 to 53). Two of the included studies were placebo-controlled. All patients were receiving Renin-Angiotensin System Inhibitors (RASIs). Patients who received budesonide therapy had significantly lower microhematuria (RR 0.67; 95% CI 0.57-0.80; p<0.01; Fig. A) compared with control. Patients who received budesonide therapy higher eGFR (RR 8.54; CI 4.65-12.43; p<0.01; Fig. B), albeit with higher incidence of hypertension (RR 3.72; 95% CI 1.66-8.35; p<0.01; Fig. C). There was no statistically significant difference in adverse events between groups (RR 1.07; 95% CI 0.97-1.18; p=0.15; Fig. D).

Conclusions

In patients with IgA nephropathy, budesonide was associated with a lower incidence of microhematuria and higher eGFR, without compromising patients’ safety. Our findings suggest that budesonide may be considered as an adjunctive therapy.

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