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Prednisone + cilazapril/losartan is a combination therapeutic regimen investigated for the treatment of primary IgA nephropathy (IgAN). It consists of prednisone, a synthetic glucocorticoid with potent anti-inflammatory and immunosuppressive effects, combined with either cilazapril, an angiotensin-converting enzyme (ACE) inhibitor, or losartan, an angiotensin II receptor blocker (ARB). This dual-pronged approach targets both the immunological drivers of the disease and the hemodynamic factors that contribute to progressive kidney damage. Prednisone works by suppressing the immune response and reducing the formation of IgA immune complexes, while cilazapril and losartan provide renoprotection by reducing systemic and glomerular blood pressure and decreasing proteinuria. This regimen was notably evaluated in a multicenter randomized controlled trial sponsored by Peking University, which demonstrated that the addition of steroids to standard ACE inhibitor or ARB therapy significantly improved kidney survival and reduced protein excretion in patients with moderately severe IgA nephropathy.
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