Table 1 Studies examining the efficacy of PTX on non-diabetic proteinuria
From: Therapeutic efficacy of pentoxifylline on proteinuria and renal progression: an update
Investigators, years [Ref.] | Patients, number | Study design | PTX dose, duration | Background RAS blockade | Main outcome findings | Safety profiles |
|---|---|---|---|---|---|---|
Chen et al., 2006 [24] | Subnephrotic GN CKD stages 1 to 4, N = 17 | Open-label, single arm | 800 mg/day (400 mg twice daily), 6 months | No RAS blockade or immune-suppressive agents | The use of PTX reduced proteinuria, in conjunction with a decrease in urinary MCP-1. | None discontinued the treatment due to adverse effects. One (6%) patient experienced gastric upset that disappeared after taking the drug after meals. |
Shu et al., 2007 [27] | Chronic allograft nephropathy with proteinuria 2.65 ± 2.15 g/day and mean eGFR 38 mL/min (serum creatinine < 3 mg/dL), N = 17 | Open-label, single arm | 1200 mg/day (400 mg three times daily), 6 months | No RAS blockade, but triple immune- suppressive agents (corticosteroid, calcineurin inhibitor, mycophenolate mofetil) | PTX resulted in temporary reduction of proteinuria, and CD4+ cells bearing TNF-α and IL-10. More than 50% patients displayed stable graft function at end of 6 months | Four (23.5%) patients reported adverse effects. One patient discontinued the treatment due to headache, two others experienced transient dizziness and remained in the study. One female developed menorrhagia which resolved after withholding PTX during menstrual periods. |
Renke et al., 2010 [25] | Non-diabetic CKD stages 1 to 3 (eGFR 37–178 mL/min) with proteinuria (0.4–4.3 g/day), N = 22 | Randomized, placebo controlled cross-over Placebo ➔ PTX PTX ➔ placebo (8 dropped-out) | 1200 mg/day, 8 weeks | ACEI and/or ARB, with 14 (64%) patients receiving combined ACEI and ARB treatment | PTX reduced proteinuria (by 26%) compared to placebo. No differences in hsCRP, α1-microglobulin, urine NAG, 15-F(2)t-isoprostane. | Five patients (23%) taking PTX withdrew from the study due to digestive symptoms (nausea, dyspepsia, diarrhea). Another 3 patients resigned from participation due to personal reasons. |
Badri et al., 2013 [26] | Membranous nephropathy with proteinuria > 0.5 g/day, CKD stages 3 to 4, N = 18 | Randomized, double-blind, placebo controlled PTX + RAS blockade (n = 12) Placebo + RAS blockade (n = 6) | 800–1200 mg/day, 6 months | ACEI and/or ARB, Immune-suppressive agents in 5 (28%) patients | PTX reduced proteinuria without affecting eGFR | PTX therapy was well tolerated in this study. Two (11%) patients experienced nausea that disappeared after taking the drug after meals. No patient discontinued the drug because of adverse effects. |