Fluticasone propionate aerosol combined with ACEI/ARB reduces proteinuria in Immunoglobulin A nephropathy
China: According to a study published in BMC Nephrology, researchers have concluded that Fluticasone propionate aerosol combined with angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) can reduce proteinuria levels in managing Immunoglobulin A nephropathy. They also mentioned that it has no significant effects on renal function.
In this study entitled “The clinical efficacy of fluticasone propionate combined with ACEI/ARB in the treatment of immunoglobulin A nephropathy”, Liping Sun provided detailed findings on the background.
The most common primary glomerulopathy worldwide is IgAN. There needs to be more data on the availability of effective treatment for this condition and requires more research in this context.
Researchers investigated the clinical efficacy of fluticasone propionate aerosol combined with ACEI/ARB in IgAN management on 142 patients who were divided randomly into two groups, namely supportive care plus fluticasone group (fluticasone propionate aerosol combined with ACEI/ARB) and the supportive care group(treated with ACEI/AR). The patients were followed up at 3, 6 and 9 months, and changes in proteinuria and estimated glomerular filtration rate (eGFR) were the primary outcomes.
The study results could be summarised as follows:
- In the follow-up period, it was found that proteinuria in the supportive care plus fluticasone group was significantly lower compared with the supportive care group.
- No serious adverse events were reported.
- Fluticasone treatment did not alleviate eGFR decline.
Concluding further, they wrote that fluticasone propionate combined with ACEI/ARB effectively decreased urinary protein levels but did not delay eGFR decrease in IgAN patients in whom the diagnosis was confirmed by biopsy and proteinuria was mild to moderate.
The limitations of the study include a small sample size and short follow-up.
The study has provided crucial insight that fluticasone propionate may offer a new therapeutic option for IgAN patients because it has no adverse effects.
Further investigations are warranted.
Further reading:
Sun, L., Zi, X., Wang, Z. et al. The clinical efficacy of fluticasone propionate combined with ACEI/ARB in the treatment of Immunoglobulin A nephropathy. BMC Nephrol 24, 63 (2023). https://doi.org/10.1186/s12882-023-03106-4
