Clinical Rheumatology and Related Research
Online ISSN : 2189-0595
Print ISSN : 0914-8760
ISSN-L : 0914-8760
The influence of iguratimod on renal function
Eriko HasegawaDaisuke KobayashiSatoshi ItoHajime IshikawaIchiei Narita
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2019 Volume 31 Issue 2 Pages 145-154

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Abstract

Background: Iguratimod(IGU)is a conventional synthetic disease-modifying antirheumatic drug(csDMARD)developed in Japan, and its influence on the renal function is poorly understood. Aim: To evaluate the influence of IGU on renal function. Methods: We evaluated 201 patients in whom the administration of IGU for rheumatoid arthritis(RA)had been newly started in Niigata Rheumatic Center from 2015 to 2016. In December 2017, we retrospectively investigated the clinical data of patients at the time of IGU initiation and after three and six months of IGU treatment. We also assessed the changes in the RA disease activity and renal function. Regarding the patients who discontinued IGU during the observational period, the data at the time of withdrawal and three months after discontinuation were compared. Results: The RA disease activity decreased significantly after 3 months of IGU treatment(DAS28-ESR 4.1(3.2-4.8)vs. 3.2(2.3-4.1), p<0.001). The estimated glomerular filtration rate(eGFR)also decreased significantly after 3 months(77.3(63.9-91.2)vs. 68.3(54.8-81.4), p<0.001). During the first 6 months, 51 patients discontinued IGU, with a decline in the renal function mentioned as the cause in 7 cases. Among the patients who discontinued IGU, the eGFR significantly recovered at 3 months after discontinuation(70.7(57.6-79.7)vs. 75.7(63.4-88.7), p=0.002). In multiple regression analysis, significant risk factors for over 10ml/min decline of eGFR included coadministration of non-steroidal anti-inflammatory drugs(NSAIDs)(odds ratio [OR], 3.89; 95% credible interval [CrI], 8.3 to 180.0). Conclusion: Severe renal dysfunction was rare, but the eGFR significantly decreased after starting IGU. When administering IGU, we must be alert for not only hepatic but also renal dysfunction. However, recovery was observed after discontinuation, suggesting that such dysfunction is reversible.

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© 2019 The Japanese Society for Clinical Rheumatology and Related Research
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