Current knowledge of targeted-release budesonide in immunoglobulin A nephropathy: A comprehensive review

Frontiers in Immunology

Immunology

Pengtao Chen¹  Biao Jin¹  Guanlin Chen¹  Qianlong Hu¹  Yuhao Wu¹  Xiuqin Xu²  Jian Liao²  Ke Huang²  Yijing Zhou²  Shankun Zhao³ 

[1] Department of Clinical Medical School, Taizhou University, Taizhou, Zhejiang, China;Department of Nephrology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang, China;Department of Urology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China;

关键词: IgA nephropathy;    budesonide;    targeted-release formulation;    renal function;    proteinuria;   

DOI  :  10.3389/fimmu.2022.926517

 received in 2022-04-22, accepted in 2022-12-14,  发布年份 2023

来源: Frontiers

【 摘 要 】

Immunoglobulin A (IgA) nephropathy is a common autoimmune kidney disease. Accumulating studies showed that IgA nephropathy may be partially correlated with mucosal immune system dysfunction. Systemic corticosteroid treatment exerts an essential protective effect against renal deterioration in IgA nephropathy. However, long-term use of corticosteroids may cause systemic side effects. The novel targeted-release formulation (TRF) of budesonide has been shown to deliver the drug to the distal ileum with the aim of minimizing adverse events for patients with IgA nephropathy. In this review, we have summarized all the current evidence of the effects of TRF-budesonide protecting against IgA nephropathy. Three randomized controlled trials (RCTs), one cohort, two case reports, and an ongoing Phase 3 trial (Part B, NCT03643965), were under comprehensive review. These included studies demonstrated that TRF-budesonide could remarkably reduce proteinuria, hematuria, and creatinine, as well as preserve renal function. The local immunosuppressive effects exhibited by TRF-budesonide may represent a novel and promising approach to treating IgA nephropathy. However, the current evidence was only derived from limited trials. Therefore, more well-designed RCTs are still warranted to validate the curable profile of TRF-budesonide in treating IgA nephropathy.

【 授权许可】

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Copyright © 2023 Liao, Zhou, Xu, Huang, Chen, Wu, Jin, Hu, Chen and Zhao