{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T15:44:22Z","timestamp":1778341462707,"version":"3.51.4"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nephrol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To understand the difference in adverse events (AEs), healthcare resource utilization (HCRU), and kidney failure rates in immunoglobulin A nephropathy (IgAN) patients who initiated systemic glucocorticoid (SGC) treatment compared with those who did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The overall cohort was selected from patients with IgAN (ICD-10 codes N02.8 and N04.1) identified in the TriNetX Dataworks database between January 2011 and May 2022. New initiators of dexamethasone, prednisone, prednisolone, or methylprednisolone (SGC cohort) were propensity score (PS) matched 1:1 with patients who did not receive SGC (non-SGC cohort) based on their characteristics at diagnosis. The index date was the date of SGC initiation; for the non-SGC cohort, a pseudo-index date was assigned using the same lag from diagnosis to index date as their PS-matched pairs. Patients with kidney failure before the index\/pseudo-index date and their 1:1 PS-matched pairs were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final analysis was conducted in 802 patients (401 PS-matched pairs, mean age 41.2 years, 55% male). Median duration of follow-up was 3.5 and 3.1 years for the SGC and non-SGC cohorts, respectively. Compared with the non-SGC cohort, patients in the SGC cohort had greater frequency of several AEs, including severe infections, greater annualized HCRU and costs, and greater incidence of kidney failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study found that SGC therapy may increase adverse reactions and HCRU in IgAN patients, while comparatively providing no beneficial effects on preserving kidney function.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneph.2025.1574239","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T05:31:14Z","timestamp":1745472674000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Real-world challenges associated with the use of four common systemic glucocorticoids in a United States IgAN cohort"],"prefix":"10.3389","volume":"5","author":[{"given":"Giancarlo","family":"Pesce","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mit","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaelle","family":"Gusto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ananth","family":"Kadambi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aastha","family":"Chandak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri","family":"Madison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2021.05.021","article-title":"KDIGO 2021 clinical practice guideline for the management of glomerular diseases","volume":"100","year":"2021","journal-title":"Kidney Int"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1206793","article-title":"IgA nephropathy","volume":"368","author":"Wyatt","year":"2013","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000135","article-title":"Long-term outcomes in igA nephropathy","volume":"18","author":"Pitcher","year":"2023","journal-title":"Clin J Am Soc Nephrol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.36469\/00001","article-title":"A systematic literature review of the epidemiology, health-related quality of life impact, and economic burden of immunoglobulin A nephropathy","volume":"8","author":"Kwon","year":"2021","journal-title":"J Health Econ Outcomes Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"100693","DOI":"10.1016\/j.xkme.2023.100693","article-title":"Impact of proteinuria and kidney function decline on health care costs and resource utilization in adults with igA nephropathy in the United States: A retrospective analysis","volume":"5","author":"Lerma","year":"2023","journal-title":"Kidney Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S171","DOI":"10.1016\/j.jval.2023.03.922","article-title":"D.; zhou, Z.Y.; shi, S.; lin, Y.; shi, L. EPH40 A retrospective cohort study of veteran\u2032s affairs data: epidemiology, treatments, clinical outcomes, and burden of immunoglobulin a nephropathy","volume":"26","author":"Bensink","year":"2023","journal-title":"Value Health"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s41669-023-00415-0","article-title":"Humanistic and economic burden of igA nephropathy: systematic literature reviews and narrative synthesis","volume":"7","author":"Jhaveri","year":"2023","journal-title":"Pharmacoecon Open"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.5368","article-title":"Effect of oral methylprednisolone on decline in kidney function or kidney failure in patients with igA nephropathy: the TESTING randomized clinical trial","volume":"327","author":"Lv","year":"2022","journal-title":"JAMA"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415463","article-title":"Intensive supportive care plus immunosuppression in igA nephropathy","volume":"373","author":"Rauen","year":"2015","journal-title":"New Engl J Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.04.046","article-title":"After ten years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy","volume":"98","author":"Rauen","year":"2020","journal-title":"Kidney Int"},{"key":"B11","doi-asserted-by":"publisher","first-page":"100760","DOI":"10.1016\/j.xkme.2023.100760","article-title":"Kidney failure attributed to focal segmental glomerulosclerosis: A USRDS retrospective cohort study of epidemiology, treatment modalities, and economic burden","volume":"6","author":"Bensink","year":"2024","journal-title":"Kidney Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/0010-468X(74)90011-7","article-title":"A computer program for linear logistic regression analysis","volume":"4","author":"Lee","year":"1974","journal-title":"Comput Programs Biomedicine"},{"key":"B13","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"key":"B14","volume-title":"MEPS HC-229E: 2021 Emergency Room Visits.","year":"2023"},{"key":"B15","volume-title":"MEPS HC-229D: 2021 Hospital Inpatient Stays.","year":"2023"},{"key":"B16","volume-title":"MEPS HC-229F: 2021 Outpatient Department Visits.","year":"2023"},{"key":"B17","volume-title":"ICD-10 Coordination and Maintenance Committee Meeting, September 13-14, 2022. Diagnosis Agenda","year":"2022"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00569-X","article-title":"Sparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial","volume":"401","author":"Heerspink","year":"2023","journal-title":"Lancet"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01554-4","article-title":"Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy (NefIgArd): 2-year results from a randomised phase 3 trial","volume":"402","author":"Lafayette","year":"2023","journal-title":"Lancet"}],"container-title":["Frontiers in Nephrology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneph.2025.1574239\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T05:31:16Z","timestamp":1745472676000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneph.2025.1574239\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,24]]},"references-count":19,"alternative-id":["10.3389\/fneph.2025.1574239"],"URL":"https:\/\/doi.org\/10.3389\/fneph.2025.1574239","relation":{},"ISSN":["2813-0626"],"issn-type":[{"value":"2813-0626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,24]]},"article-number":"1574239"}}