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Outcome of severe steroid-dependent nephrotic syndrome treated with mycophenolate mofetil

Sushmita Banerjee1, Amitava Pahari, Jayati Sengupta

  • 1Institute of Child Health, 9 Greek Church Row Extension, Kolkata, India. asban444@gmail.com

Pediatric Nephrology (Berlin, Germany)
|August 15, 2012
PubMed
Abstract

Insights

Mycophenolate mofetil (MMF) offers long-term steroid-sparing benefits for pediatric nephrotic syndrome (NS) patients. Over 50% of severe steroid-dependent NS cases avoided further immunosuppression with MMF therapy.

Area of Science:

  • Pediatric Nephrology
  • Immunosuppressive Therapy

Background:

  • Mycophenolate mofetil (MMF) is utilized as a steroid-sparing agent in pediatric nephrotic syndrome (NS).
  • Limited data exists on the long-term efficacy and safety of MMF in this population.

Purpose of the Study:

  • To evaluate the long-term outcomes of Mycophenolate mofetil (MMF) therapy in pediatric patients with steroid-dependent nephrotic syndrome (SDNS).

Main Methods:

  • A cohort of 46 pediatric NS patients, steroid-dependent despite prior levamisole and cyclophosphamide treatment, received MMF.
  • Long-term outcomes, including steroid requirements, relapse rates, and adverse events, were assessed.

Main Results:

  • Within one year, 70% of patients showed reduced steroid needs, with 20 achieving complete steroid cessation.
  • At a mean follow-up of 3.56 years, 54% of children no longer required alternative immunosuppression (IS), experiencing infrequent relapses.
  • One patient experienced a psoriasis flare; no other permanent drug withdrawals due to side effects were noted.

Conclusions:

  • Long-term Mycophenolate mofetil (MMF) therapy is safe for pediatric nephrotic syndrome (NS) patients.
  • MMF enables over 50% of severe steroid-dependent NS patients to avoid additional toxic immunosuppressive (IS) agents.

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