Follow-up of phase I trial of adalimumab and rosiglitazone in FSGS: III. Report of the FONT study group Public Deposited

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Creator
  • Kump, Theresa
    • Other Affiliation: Department of Pediatrics, Division of Nephrology, Children’s Hospital of Wisconsin, 999 North 92nd Street, Wauwatosa, WI 53227, USA
  • Vento, Suzanne
    • Other Affiliation: Department of Pediatrics, Division of Nephrology, Schneider Children’s Hospital of North Shore-LIJ Health System, 269-01 76th Avenue, New Hyde Park, NY 11040, USA
  • Peyser, Alexandra
    • Other Affiliation: Department of Pediatrics, Division of Nephrology, Schneider Children’s Hospital of North Shore-LIJ Health System, 269-01 76th Avenue, New Hyde Park, NY 11040, USA
  • Trachtman, Howard
    • Other Affiliation: Department of Pediatrics, Division of Nephrology, Schneider Children’s Hospital of North Shore-LIJ Health System, 269-01 76th Avenue, New Hyde Park, NY 11040, USA
  • MacHardy, Nathaniel
    • Affiliation: School of Medicine, Department of Medicine, Division of Nephrology and Hypertension, UNC Kidney Center
  • Tarapore, Freya
    • Other Affiliation: Department of Pediatrics, Division of Nephrology, Schneider Children’s Hospital of North Shore-LIJ Health System, 269-01 76th Avenue, New Hyde Park, NY 11040, USA
  • Gipson, Debbie S
    • Affiliation: School of Medicine, Department of Medicine, Division of Nephrology and Hypertension, UNC Kidney Center
  • MacHardy, Jacqueline
    • Affiliation: School of Medicine, Department of Medicine, Division of Nephrology and Hypertension, UNC Kidney Center
  • Savin, Virginia
    • Other Affiliation: Department of Medicine, Division of Nephrology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
  • Pan, Cynthia
    • Other Affiliation: Department of Pediatrics, Division of Nephrology, Children’s Hospital of Wisconsin, 999 North 92nd Street, Wauwatosa, WI 53227, USA
  • Powell, Leslie M
    • Affiliation: School of Medicine, Department of Medicine, Division of Nephrology and Hypertension, UNC Kidney Center
Abstract
  • Abstract Background Patients with resistant primary focal segmental glomerulosclerosis (FSGS) are at high risk of progression to chronic kidney disease stage V. Antifibrotic agents may slow or halt this process. We present outcomes of follow-up after a Phase I trial of adalimumab and rosiglitazone, antifibrotic drugs tested in the Novel Therapies in Resistant FSGS (FONT) study. Methods 21 patients -- 12 males and 9 females, age 16.0 ± 7.5 yr, and estimated GFR (GFRe) 121 ± 56 mL/min/1.73 m2 -- received adalimumab (n = 10), 24 mg/m2 every 14 days or rosiglitazone (n = 11), 3 mg/m2 per day for 16 weeks. The change in GFRe per month prior to entry and after completion of the Phase I trial was compared. Results 19 patients completed the 16-week FONT treatment phase. The observation period pre-FONT was 18.3 ± 10.2 months and 16.1 ± 5.7 months after the study. A similar percentage of patients, 71% and 56%, in the rosiglitazone and adalimumab cohorts, respectively, had stabilization in GFRe, defined as a reduced negative slope of the line plotting GFRe versus time without requiring renal replacement therapy after completion of the FONT treatment period (P = 0.63). Conclusion Nearly 50% of patients with resistant FSGS who receive novel antifibrotic agents may have a legacy effect with delayed deterioration in kidney function after completion of therapy. Based on this proof-of-concept preliminary study, we recommend long-term follow-up of patients enrolled in clinical trials to ascertain a more comprehensive assessment of the efficacy of experimental treatments.
Date of publication
Identifier
  • 20113498
  • doi:10.1186/1471-2369-11-2
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Alexandra Peyser et al.; licensee BioMed Central Ltd.
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Journal title
  • BMC Nephrology
Journal volume
  • 11
Journal issue
  • 1
Page start
  • 2
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1471-2369
Bibliographic citation
  • BMC Nephrology. 2010 Jan 29;11(1):2
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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