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Levamisole therapy in children with frequently relapsing and steroid-dependent nephrotic syndrome: a single-center

Elżbieta Kuźma-Mroczkowska1, Piotr Skrzypczyk1, Małgorzata Pańczyk-Tomaszewska1

  • 1Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland.

Central-European Journal of Immunology
|November 12, 2016
PubMed

Insights

Levamisole effectively reduces relapses in children with frequently relapsing and steroid-dependent nephrotic syndrome (FRNS/SDNS). However, early proteinuria relapse indicates limited benefit from continued levamisole treatment in these patients.

Area of Science:

  • Pediatric Nephrology
  • Immunopharmacology
  • Clinical Therapeutics

Background:

  • Levamisole, an immunomodulatory antihelmintic, is suggested to decrease relapses in children with frequently relapsing and steroid-dependent nephrotic syndrome (FRNS/SDNS).
  • This study details a single center's experience using levamisole for FRNS/SDNS treatment.

Purpose of the Study:

  • To evaluate the efficacy of levamisole in managing FRNS/SDNS in pediatric patients.
  • To analyze treatment duration, relapse rates, and side effects associated with levamisole therapy.

Main Methods:

  • Retrospective analysis of 53 children with FRNS/SDNS treated with levamisole for at least 6 months (1984-2011).
  • Evaluation of disease course, renal biopsy, concomitant medications, prednisone dosage, levamisole duration, relapse frequency, and adverse events.
  • Statistical analysis of relapse rates before and during levamisole treatment.

Main Results:

  • Patients received levamisole for a mean of 15.0 ±7.3 months, with a mean prednisone dose of 1.2 ±0.6 mg/kg/24 h at initiation.
  • Proteinuria relapsed in 64.2% of children, with the first relapse occurring at a mean of 8.8 ±8.1 months.
  • Levamisole significantly reduced the annual relapse rate from 2.7 ±2.0 to 1.8 ±2.1 (p = 0.02), with earlier relapses correlating with higher overall relapse numbers.

Conclusions:

  • Levamisole demonstrates effectiveness in reducing relapse frequency in pediatric FRNS/SDNS.
  • Early relapse of proteinuria during levamisole therapy suggests a poorer response and limited benefit from its continuation.
Abstract

Keywords:
childrenimmunomodulationlevamisolenephrotic syndrome

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