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Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome

We performed a multi-centre randomized controlled trial to compare the efficacy of mycophenolate mofetil (MMF) to that of cyclosporine A (CsA) in treating children with frequently relapsing nephrotic syndrome and biopsy-proven minimal change disease. Of the 31 randomized initially selected patients,...

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Autores principales: Dorresteijn, Eiske M., Kist-van Holthe, Joana E., Levtchenko, Elena N., Nauta, Jeroen, Hop, Wim C. J., van der Heijden, Albert J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462920/
https://www.ncbi.nlm.nih.gov/pubmed/18622632
http://dx.doi.org/10.1007/s00467-008-0899-6
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author Dorresteijn, Eiske M.
Kist-van Holthe, Joana E.
Levtchenko, Elena N.
Nauta, Jeroen
Hop, Wim C. J.
van der Heijden, Albert J.
author_facet Dorresteijn, Eiske M.
Kist-van Holthe, Joana E.
Levtchenko, Elena N.
Nauta, Jeroen
Hop, Wim C. J.
van der Heijden, Albert J.
author_sort Dorresteijn, Eiske M.
collection PubMed
description We performed a multi-centre randomized controlled trial to compare the efficacy of mycophenolate mofetil (MMF) to that of cyclosporine A (CsA) in treating children with frequently relapsing nephrotic syndrome and biopsy-proven minimal change disease. Of the 31 randomized initially selected patients, seven were excluded. The remaining 24 children received either MMF 1200 mg/m(2) per day (n = 12) or CsA 4–5 mg/kg per day (n = 12) during a 12-month period. Of the 12 patients in the MMF group, two discontinued the study medication. Evaluation of the changes from the baseline glomerular filtration rate showed an overall significant difference in favour of MMF over the treatment period (p = 0.03). Seven of the 12 patients in the MMF group and 11 of the 12 patients in the CsA group remained in complete remission during the entire study period. Relapse rate in the MMF group was 0.83/year compared to 0.08/year in the CsA group (p = 0.08). None of the patients reported diarrhea. Pharmacokinetic profiles of mycophenolic acid were performed in seven patients. The patient with the lowest area under the curve had three relapses within 6 months. In children with frequently relapsing minimal change nephrotic syndrome, MMF has a favourable side effect profile compared to CsA; however, there is a tendency towards a higher relapse risk in patients treated with MMF.
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spelling pubmed-74629202020-09-11 Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome Dorresteijn, Eiske M. Kist-van Holthe, Joana E. Levtchenko, Elena N. Nauta, Jeroen Hop, Wim C. J. van der Heijden, Albert J. Pediatr Nephrol Original Article We performed a multi-centre randomized controlled trial to compare the efficacy of mycophenolate mofetil (MMF) to that of cyclosporine A (CsA) in treating children with frequently relapsing nephrotic syndrome and biopsy-proven minimal change disease. Of the 31 randomized initially selected patients, seven were excluded. The remaining 24 children received either MMF 1200 mg/m(2) per day (n = 12) or CsA 4–5 mg/kg per day (n = 12) during a 12-month period. Of the 12 patients in the MMF group, two discontinued the study medication. Evaluation of the changes from the baseline glomerular filtration rate showed an overall significant difference in favour of MMF over the treatment period (p = 0.03). Seven of the 12 patients in the MMF group and 11 of the 12 patients in the CsA group remained in complete remission during the entire study period. Relapse rate in the MMF group was 0.83/year compared to 0.08/year in the CsA group (p = 0.08). None of the patients reported diarrhea. Pharmacokinetic profiles of mycophenolic acid were performed in seven patients. The patient with the lowest area under the curve had three relapses within 6 months. In children with frequently relapsing minimal change nephrotic syndrome, MMF has a favourable side effect profile compared to CsA; however, there is a tendency towards a higher relapse risk in patients treated with MMF. Springer Berlin Heidelberg 2008-11-01 2008 /pmc/articles/PMC7462920/ /pubmed/18622632 http://dx.doi.org/10.1007/s00467-008-0899-6 Text en © The Author(s) 2008 https://creativecommons.org/licenses/by-nc/2.0/Open AccessThis is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (https://creativecommons.org/licenses/by-nc/2.0 (https://creativecommons.org/licenses/by-nc/2.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Original Article
Dorresteijn, Eiske M.
Kist-van Holthe, Joana E.
Levtchenko, Elena N.
Nauta, Jeroen
Hop, Wim C. J.
van der Heijden, Albert J.
Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome
title Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome
title_full Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome
title_fullStr Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome
title_full_unstemmed Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome
title_short Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome
title_sort mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462920/
https://www.ncbi.nlm.nih.gov/pubmed/18622632
http://dx.doi.org/10.1007/s00467-008-0899-6
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