Comparable Outcomes Using Oral Methylprednisolone vs. Prednisone in IgA Nephropathy: A Retrospective Cohort Study

Background: To compare effectiveness and adverse reactions after oral methylprednisolone versus prednisone in patients with IgA nephropathy. Methods: A retrospective cohort study was conducted in 85 patients with IgA nephropathy. Patients were divided into three groups: 34 patients received oral methylprednisolone of 0.4 mg/kg/d (MP-QD group), 31 patients received prednisone of 0.5 mg/kg/d (PND-QD group), and 20 patients received prednisone of 0.5 mg/kg on alternate days (PND-QOD group). The levels of creatinine and proteinuria, and adverse reactions were monitored for 6 months of follow-up. Results: The excretion of urine protein at 24h was significantly decreased while serum creatinine was not significantly changed after corticosteroids treatment. 20 adverse events were observed in 16 participants (47.1%) in the MP-QD group, 8 adverse events were observed in 7 participants (22.5%) in the PDN-QD group, and 2 adverse events were observed in 2 participants (10%) in the PDN-QOD group. The risk of adverse events in PDN-QD and PDN-QOD groups was lower than that in MP-QD group with a risk difference of 40.4% (95% CI, 16.6 to 98.2%, P = 0.045) for the comparison of PDN-QD vs MP-QD, and a risk difference of 17.2% (95% CI, 4.1 to 75.1%, P = 0.019) for the comparison of PDN-QOD vs MP-QD. Conclusions: Oral methylprednisolone or prednisone therapy in patients with IgA nephropathy significantly decreased the excretion of proteinuria and no obvious change was found in the level of serum creatinine in 6-month follow-up period. However, more adverse effects were observed in the patients who received oral methylprednisolone. Funding Information: None. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: This study was conducted in accordance with the ethical principles of the Declaration of Helsinki and with the Methods for the Ethical Review of Biomedical Research Involving Humans issued by the National Health and Family Planning Commission of China. The study was approved by the Ethics Review Committee of Sixth Affiliated Hospital of Sun Yat-sen University (ID: 2020ZSLYEC-224). As the data were obtained retrospectively from patient charts, it is impossible to recall each patient one by one and sign the inform consents form in person and the research project does not involve personal privacy or commercial interests, informed consent was deemed unnecessary following the above guidelines.