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Outcome of children with IgA vasculitis with nephritis treated with steroids: a matched controlled study

dc.rights.licenseopenen_US
dc.contributor.authorMARY, Anne-Lise
dc.contributor.authorCLAVE, Stephanie
dc.contributor.authorROUSSET-ROUVIERE, Caroline
dc.contributor.authorBERARD, Etienne
dc.contributor.authorBOYER, Olivia
dc.contributor.authorDECRAMER, Stephane
dc.contributor.authorFILA, Marc
dc.contributor.authorGUIGONIS, Vincent
dc.contributor.authorCLOAREC, Sylvie
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorHARAMBAT, Jerome
IDREF: 110567358
dc.contributor.authorHOGAN, Julien
dc.contributor.authorLAHOCHE, Annie
dc.contributor.authorROUSSEY-KESLER, Gwenaelle
dc.contributor.authorZALOSZYC, Ariane
dc.contributor.authorULINSKI, Tim
dc.contributor.authorPARMENTIER, Cyrielle
dc.contributor.authorDELBET, Jean-Daniel
dc.date.accessioned2023-06-23T13:25:30Z
dc.date.available2023-06-23T13:25:30Z
dc.date.issued2023-05-08
dc.identifier.issn1432-198X (Electronic) 0931-041X (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/182793
dc.description.abstractEnBACKGROUND: IgA vasculitis (IgAV) is the most common vasculitis in children. IgAV long-term prognosis depends on kidney involvement or IgA vasculitis with nephritis (IgAVN). To date, steroid treatment (oral steroids or methylprednisolone pulses) has not proven to be formally efficient. This study aimed to assess the role of steroids on IgAVN outcome. METHODS: All children with IgAVN diagnosed 2000-2019 in 14 French pediatric nephrology units with minimal follow-up of 6 months were retrospectively included. Outcomes of patients treated with steroids were compared with those of a control group of untreated patients matched for age, sex, proteinuria, eGFR, and histological features. The primary endpoint was IgAVN remission defined as urine protein-to-creatinine ratio < 20 mg/mmol without impaired eGFR one year after disease onset. RESULTS: A total of 359 patients with IgAVN were included with a median follow-up time of 249 days (range 43-809). One hundred eight (30%) patients received oral steroids alone, 207 (51%) patients received three methylprednisolone pulses followed by oral steroids, and 44 patients (12.5%) did not receive steroids. Thirty-two children treated with oral steroids alone were compared with 32 matched control patients who did not receive steroids. One year after disease onset, IgAVN remission proportion was not different between these two groups: 62% versus 68%, respectively. Ninety-three children treated with oral steroids alone were compared with 93 matched patients treated with three methylprednisolone pulses followed by oral corticosteroids. IgAVN remission proportion was not different between these two groups: 77% versus 73%, respectively. CONCLUSION: The benefit of oral steroids alone and methylprednisolone pulses could not be established based on this observational study. Randomized controlled trials are thus required to determine the efficacy of steroids in IgAVN. A higher resolution version of the Graphical abstract is available as Supplementary information.
dc.language.isoENen_US
dc.subject.enHenoch–Schonlein purpura nephritis
dc.subject.enIgA vasculitis with nephritis
dc.subject.enRenal outcome
dc.subject.enSteroids
dc.title.enOutcome of children with IgA vasculitis with nephritis treated with steroids: a matched controlled study
dc.title.alternativePediatr Nephrolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1007/s00467-023-05981-3en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed37154959en_US
bordeaux.journalPediatric Nephrologyen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamLEHA_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-04139435
hal.version1
hal.date.transferred2023-06-23T13:25:33Z
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Pediatric%20Nephrology&amp;rft.date=2023-05-08&amp;rft.eissn=1432-198X%20(Electronic)%200931-041X%20(Linking)&amp;rft.issn=1432-198X%20(Electronic)%200931-041X%20(Linking)&amp;rft.au=MARY,%20Anne-Lise&amp;CLAVE,%20Stephanie&amp;ROUSSET-ROUVIERE,%20Caroline&amp;BERARD,%20Etienne&amp;BOYER,%20Olivia&amp;rft.genre=article


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