{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:02:42Z","timestamp":1783616562397,"version":"3.55.0"},"reference-count":19,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Nephrol"],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; Adrenocorticotropic hormone (ACTH) has shown promising results in glomerular diseases resistant to conventional therapies, but the reported data have solely been from retrospective, observational studies. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; In this prospective, open-label study (NCT01129284), 15 subjects with resistant glomerular diseases were treated with ACTH gel (80 units subcutaneously twice weekly) for 6 months. Resistant membranous nephropathy (MN), minimal change disease (MCD), and focal segmental glomerulosclerosis (FSGS) were defined as failure to achieve sustained remission of proteinuria off immunosuppressive therapy with at least 2 treatment regimens; resistant IgA nephropathy was defined as &gt;1 g\/g urine protein:creatinine ratio despite maximally tolerated RAAS blockade. Remission was defined as stable or improved renal function with \u226550% reduction in proteinuria to &lt;0.5 g\/g (complete remission) or 0.5\u20133.5 g\/g (partial remission). &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; The study included 5 subjects with resistant idiopathic MN, 5 subjects with resistant MCD (n = 2)\/FSGS (n = 3), and 5 subjects with resistant IgA nephropathy. Two resistant MN subjects achieved partial remission on ACTH therapy, although 3 achieved immunologic remission of disease (PLA&lt;sub&gt;2&lt;\/sub&gt;R antibody disappeared by 4 months of therapy). One subject with resistant FSGS achieved complete remission on ACTH; one subject with resistant MCD achieved partial remission but relapsed within 4 weeks of stopping ACTH. Two subjects with resistant IgA nephropathy demonstrated &gt;50% reductions in proteinuria while on ACTH, with proteinuria consistently &lt;1 g\/g by 6 months. Three of 15 subjects reported significant steroid-like adverse effects with ACTH, including weight gain and hyperglycemia, prompting early termination of therapy without any clinical response. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; ACTH gel is a promising treatment for resistant glomerular diseases and should be studied further in controlled trials against currently available therapies for resistant disease.<\/jats:p>","DOI":"10.1159\/000339287","type":"journal-article","created":{"date-parts":[[2012,6,19]],"date-time":"2012-06-19T08:42:49Z","timestamp":1340095369000},"page":"58-67","source":"Crossref","is-referenced-by-count":78,"title":["Treatment of Resistant Glomerular Diseases with Adrenocorticotropic Hormone Gel: A Prospective Trial"],"prefix":"10.1159","volume":"36","author":[{"given":"Andrew S.","family":"Bomback","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro A.","family":"Canetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence H.","family":"Beck Jr.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rivka","family":"Ayalon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai","family":"Radhakrishnan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald B.","family":"Appel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2012,6,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.2215%2FCJN.03531006"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1046%2Fj.1523-1755.2001.0590041484.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1046%2Fj.1523-1755.1999.00778.x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1681%2FASN.2004070593"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1093%2Fndt%2Fgfh110"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1046%2Fj.1523-1755.1999.00675.x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.2147%2FDDDT.S17521"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1681%2FASN.2009101025"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.ajkd.2005.10.016"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1056%2FNEJMoa0810457"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1681%2FASN.2007050526"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097%2F01.ASN.0000068460.37369.DC"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093%2Fndt%2Fgfp356"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.ajkd.2008.07.029"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.2215%2FCJN.05231008"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1038%2Fsj.ki.5002628"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.ajkd.2008.04.013"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.2215%2FCJN.00570109"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.2215%2FCJN.06041108"}],"container-title":["American Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/339287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/339287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T18:27:34Z","timestamp":1745432854000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000339287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2012,7,1]]},"published-print":{"date-parts":[[2012,7,17]]}},"URL":"https:\/\/doi.org\/10.1159\/000339287","archive":["Portico"],"relation":{},"ISSN":["0250-8095","1421-9670"],"issn-type":[{"value":"0250-8095","type":"print"},{"value":"1421-9670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012]]}}}