Prospective multicentric open-label randomized controlled trial done in Germany in which supportive care alone versus supportive care with immunosuppressive therapy were studied in 309 patients between age group of 18 to 70 years with IgA nephropathy with a proteinuria of 0.75 g/day, GFR < 90 or both after optimal run in phase of 6 months of supportive therapy.The immunosuppressive regimen consisted of glucocorticoids in patient with GFR > 60 and a combination of steroids and cyclophosphamide followed by azathioprine in patients with GFR between 30 and 59 with two hierarchical primary end points which were i) full clinical remission at the end of the trial (UPCR <0.2 and stable renal function with decrease in eGFR of <5 ml/min from baseline at the end of 3 years) and decrease in eGFR of at least 15 ml/min from baseline.There was a significantly higher degree of remission of proteinuria in the immunosuppressive group but with no significant differences in the GFR between two groups. More episodes of severe and non severe infections were found in the immunosuppressive groups as compared to non immunosuppressive groups.
