{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:34:31Z","timestamp":1790663671684,"version":"4.1.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T00:00:00Z","timestamp":1701648000000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009155","name":"Otsuka America Pharmaceutical, Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Immunoglobulin A nephropathy (IgAN) is a common glomerulonephritis partially correlated with mucosal immune system dysfunction. Progressive renal failure occurs in many patients, with about 30\u201350% of the patients with IgAN developing end-stage kidney disease (ESKD). Many treatments have been used for decades, despite uncertainty about their effectiveness and the ideal dose. Randomised controlled trials reported that systemic glucocorticoids can be an effective treatment for patients with persistent and significant proteinuria despite renin-angiotensin system inhibitors use possibly causing systemic side effects. The primary focus of IgAN management should be based on optimised supportive care, including renin-angiotensin system (RAS) blockade and now SGLT2 inhibitors. The novel targeted-release formulation (TRF) of budesonide has been tested to reduce the adverse events of systemic steroids by delivering the drug to the distal ileum. The local efficacy of TRF-budesonide may represent a novel and promising approach to treating IgAN. Two clinical trials showed that TRF-budesonide could significantly reduce proteinuria and haematuria and possibly preserve renal function while significantly reducing the side effects. However, the limited number of treated patients and the relatively short follow-up suggest caution before considering budesonide superior to the current six-months steroid pulses scheme. Long-term data on the efficacy and safety of TRF budesonide are awaited, together with the design of trials with a head-to-head comparison with systemic steroids before considering TRF-budesonide as the standard of care treatment for IgAN nephropathy.<\/jats:p>","DOI":"10.1093\/ckj\/sfad224","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T20:06:46Z","timestamp":1701720406000},"page":"ii40-ii46","source":"Crossref","is-referenced-by-count":20,"title":["Systemic and targeted steroids for the treatment of IgA nephropathy"],"prefix":"10.1093","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-261X","authenticated-orcid":false,"given":"Francesco","family":"Locatelli","sequence":"first","affiliation":[{"name":"Department of Nephrology and Dialysis, Alessandro Manzoni Hospital , Lecco , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Del Vecchio","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Dialysis, Sant\u2019 Anna Hospital , ASST Lariana, Como , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Ponticelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,4]]},"reference":[{"key":"2023120420063703000_bib1","first-page":"503","article-title":"Factors predicting progression of IgA nephropathy","volume":"18","author":"Coppo","year":"2005","journal-title":"J Nephrol"},{"key":"2023120420063703000_bib2","doi-asserted-by":"crossref","first-page":"e51225","DOI":"10.1371\/journal.pone.0051225","article-title":"Mortality of IgA nephropathy patients: a single center experience over 30 years","volume":"7","author":"Lee","year":"2012","journal-title":"PLoS One"},{"key":"2023120420063703000_bib3","doi-asserted-by":"crossref","first-page":"e91756","DOI":"10.1371\/journal.pone.0091756","article-title":"Prognosis in IgA nephropathy: 30-year analysis of 1,012 patients at a single center in Japan","volume":"9","author":"Moriyama","year":"2014","journal-title":"PLoS One"},{"key":"2023120420063703000_bib4","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1681\/ASN.2018101017","article-title":"Mortality in IgA nephropathy: a nationwide population-based cohort study","volume":"30","author":"Jarrick","year":"2019","journal-title":"JASN"},{"key":"2023120420063703000_bib5","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1038\/ki.2015.241","article-title":"Identifying the ideal metric of proteinuria as a predictor of renal outcome in idiopathic glomerulonephritis","volume":"88","author":"Barbour","year":"2015","journal-title":"Kidney Int"},{"key":"2023120420063703000_bib6","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s00467-016-3469-3","article-title":"Risk factors for progression in children and young adults with IgA nephropathy. 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