Traditional, alternative, and emerging therapeutics for focal segmental glomerulosclerosis.

IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY
Expert Opinion on Pharmacotherapy Pub Date : 2025-02-01 Epub Date: 2025-01-01 DOI:10.1080/14656566.2024.2446621
Silvia Di Carlo, Elisa Longhitano, Claudia Spinella, Veronica Maressa, Chiara Casuscelli, Luigi Peritore, Domenico Santoro
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引用次数: 0

Abstract

Introduction: Segmental focal glomerulosclerosis is a histological lesion characterized by podocyte damage. It may be a primary disease linked to an unknown circulating factor, secondary to viral infections, drug toxicity, or a disadaptive response to the loss of nephrons, or it may depend on gene mutations or have an indeterminate cause. The treatment of the primary form involves immunosuppressors. Additional pharmacotherapies for residual proteinuria are used, and emerging therapies are being studied to target other pathological pathways.

Areas covered: This paper covers the treatment of FSGS, focusing on traditional and emerging therapeutic strategies. It is based on the KDIGO 2021 guidelines and supplemented by a literature search conducted on PubMed.

Expert opinion: Treating FSGS is challenging due to its heterogeneity. Immunosuppression is adequate for primary FSGS but harmful in genetic or secondary forms. Key strategies include targeting the underlying cause and using agents that affect renal hemodynamics. Antifibrotic drugs can help slow kidney damage by addressing chronic inflammation and fibrosis. Alongside pharmacological treatments, managing blood pressure and restricting dietary salt are crucial. Finally, personalized treatment requires stratifying patients based on clinical, genetic, and histological data to improve clinical trial design and outcomes.

局灶节段性肾小球硬化的传统、替代和新兴治疗方法。
节段性局灶性肾小球硬化是一种以足细胞损伤为特征的组织学病变。它可能是一种与未知循环因子相关的原发疾病,继发于病毒感染、药物毒性或对肾单位损失的不适应反应,也可能取决于基因突变或具有不确定的原因。原发形式的治疗包括免疫抑制剂。剩余蛋白尿的其他药物治疗被使用,新兴疗法正在研究针对其他病理途径。涵盖领域:本文涵盖了FSGS的治疗,重点介绍了传统的和新兴的治疗策略。它以KDIGO 2021指南为基础,并辅以PubMed上的文献检索。专家意见:由于其异质性,治疗FSGS具有挑战性。免疫抑制对原发性FSGS是足够的,但对遗传或继发性形式有害。关键策略包括针对潜在原因和使用影响肾脏血流动力学的药物。抗纤维化药物可以通过解决慢性炎症和纤维化来帮助减缓肾脏损害。除了药物治疗,控制血压和限制饮食盐也至关重要。最后,个性化治疗需要根据临床、遗传和组织学数据对患者进行分层,以改进临床试验设计和结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.60
自引率
3.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Expert Opinion on Pharmacotherapy is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles and original papers on newly approved/near to launch compounds mainly of chemical/synthetic origin, providing expert opinion on the likely impact of these new agents on existing pharmacotherapy of specific diseases.
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