Patients were randomly assigned (1: 1: 1) by a random number table to receive supportive treatment only, supportive treatment plus 6 months of alternating cycles of prednisolone and chlorambucil, or supportive treatment plus 12 months of ciclosporin. The primary outcome was a further 20% decline in renal function from baseline, analysed by intention to treat. The trial is registered as an International Standard Randomised Controlled Trial, number 99959692.

Findings We randomly assigned 108 patients, 33 of whom received prednisolone and chlorambucil, 37 ciclosporin, and 38 supportive therapy alone. Two patients

(one who received ciclosporin and one who received supportive therapy) were

ineligible, so were not included in the intention-to-treat analysis, and 45 patients deviated from Lazertinib PF-04929113 cost protocol before study end, mostly as a result of minor dose adjustments. Follow up was until primary endpoint or for minimum of 3 years if primary endpoint was not reached. Risk of further 20% decline in renal function was significantly lower in the prednisolone and chlorambucil group than in the supportive care group (19 [58%] of 33 patients reached endpoint vs 31 [84%] of 37, hazard ratio [HR] 0.44 [95% CI 0.24-0.78]; p=0.0042); risk did not differ between the ciclosporin (29 [81%] of 36) and supportive treatment only groups (HR 1.17 [0.70-1.95]; p=0.54), but did differ significantly across all three groups (p=0.003). Serious adverse events were frequent in all three groups but were higher in the prednisolone and chlorambucil group than in the supportive care only group (56 events vs 24 events; p=0.048).

Interpretation For the subset of patients with idiopathic membranous nephropathy and deteriorating

excretory renal function, 6 months’ therapy with prednisolone and chlorambucil is the treatment second approach best supported by our evidence. Ciclosporin should be avoided in this subset.”
“The catechol-O-methyltransferase (COMT) gene is a candidate gene for schizophrenia as its encoded enzyme is involved in the metabolic inactivation of dopamine and noradrenaline. Several molecular genetic studies thus far have demonstrated that the COMT functional polymorphism of Val158Met is susceptible with schizophrenia. Hence, the present study aims to determine this genetic association of this SNP in the three major ethnic groups of the Malaysian population. A total of 317 patients (79 Malays, 154 Chinese and 84 Indians) meeting DSM-IV criteria for schizophrenia and 417 healthy subjects (160 Malays, 164 Chinese and 93 Indians) were recruited. A PCR-RFLP method was used to determine the genotypes and alleles present.