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This combination immunosuppressive regimen, evaluated by A. Manzoni Hospital in the Phase 4 IgANSTAZA trial, consists of the corticosteroids methylprednisolone and prednisone used in conjunction with the antimetabolite azathioprine for the treatment of IgA nephropathy. The protocol involves intravenous pulses of methylprednisolone followed by oral prednisone and daily azathioprine over a six-month period. The mechanism of action involves the activation of glucocorticoid receptors to exert anti-inflammatory effects and the inhibition of purine synthesis to suppress lymphocyte proliferation. Although intended to improve long-term renal survival, clinical trial results indicated that the addition of azathioprine did not offer superior efficacy compared to corticosteroids alone and was associated with a higher incidence of adverse events.
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