Evaluating the risk of cardiovascular events associated with different immunosuppression treatments for glomerular diseases

• DOI: 10.1016/j.kint.2024.10.015
• Publication Date: 2024-11-06T08:04:51Z
• Authors: Mark Canney; Mohammad Atiquzzaman; Yuyan Zheng; Dilshani Induruwage; Yinshan Zhao; Lee Er; Christopher B. Fo...; Sean J. Barbour
• Keywords: Immunosuppression

Patients with glomerular disease are at high risk of cardiovascular but the contribution immunosuppression to this is unclear. In retrospective cohort study 1912 patients (comprised 759 IgA nephropathy, 540 focal segmental glomerulosclerosis, 387 membranous nephropathy and 226 minimal change disease) from British Columbia, Canada, we evaluated association between exposure specific immunosuppressive medications a composite outcome including coronary artery, cerebrovascular peripheral arterial events. Survival models were adjusted for baseline factors, type disease, estimated filtration rate (eGFR) proteinuria over time. During median follow-up 6.8 years, 212 (11.1%) experienced primary outcome. Corticosteroid was not significantly associated after adjusting factors. fully models, cumulative calcineurin inhibitor modest (150-300 defined daily doses [DDD]) higher (300 or more DDD) 2-fold events (hazard ratio 2.98, 95% confidence interval 1.27-6.95) (2.78, 1.32-5.84), respectively. A peak dose antimetabolite (azathioprine, mycophenolate mofetil sodium) 0.5 DDD adjustment factors time-varying eGFR (1.70, 0.91-3.20). Each 10 grams cyclophosphamide 1.5-fold in model (1.46, 1.22-1.75) Thus, our findings suggest that therapies used treatment may have different profiles, which should be considered when deciding on individual as safety endpoint future clinical trials.Graphical abstract