[Correspondence] Targeted-release budesonide therapy for IgA nephropathy – Authors' reply

Kenji Tsuda and colleagues correctly report that the NEFIGAN study1 investigated the use of corticosteroid therapy outside of the current guidelines,2 which endorse the use of systemic corticosteroids in patients with urinary protein excretion of more than 1 g/day. However, the NEFIGAN study was not a trial of systemic corticosteroids but rather a trial of steroid therapy that targeted the intestinal mucosal immune system, with minimal systemic effects, in patients with optimised RAS blockade. We were conducting a proof-of-concept study; thus the choice of reduction in proteinuria rather than the proportion of patients entering remission defined by an arbitrary proteinuria cutoff was a more logical endpoint.
Source: LANCET - Category: General Medicine Authors: Tags: Correspondence Source Type: research