OBJECTIVES: Focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and IgA nephropathy (IgAN) are glomerular disorders with nephrotic range proteinuria. First-line treatments are corticosteroids (CS) and/or calcineurin inhibitors (CNIs). Acthar® Gel (repository corticotropin injection) is indicated for the treatment of proteinuria in nephrotic syndrome and a short-term option for patients that do not respond to CS or CNIs. This study used a large retrospective claims database (Symphony Health) to describe changes in treatment patterns of FSGS, MN, and IgAN patients after Acthar initiation.

METHODS: This study included patients (≥18 years old) initiating Acthar from 2016 through 2022 with a diagnosis for FSGS, MN, or IgAN, and 12 months of continuous enrollment pre- and post-treatment. Comparison of means or proportions at baseline and follow-up after treatment with Acthar

RESULTS: Acthar treated MN patients were older (54 years vs 46 years and 44 years), more male (60% vs 56% and 56%), and White (54% vs 25% and 44%) compared to the FSGS and IgAN cohorts, respectively. FSGS, MN, and IgAN cohorts all had a lower proportion of patients on CS at follow-up (IgAN, 67% vs 39% p=0.033), lower mean average daily dose (ADD) for extended CS use (FSGS, MN, IgAN p<0.001), and lower mean number of CS claims (MN, 2.7 vs 1.4, p=0.046), compared to baseline. All 3 cohorts had a lower proportion of patients using CNIs (FSGS, 53% vs 32% p=0.018), NSAIDs, and opioids at follow-up compared to baseline.

CONCLUSIONS: These data further our understanding of the clinical impact of Acthar® Gel treatment on concomitant therapies, particularly the potential to reduce CS and CNI medication use for FSGS, MN, and IgAN patients.