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Mycophenolate Sodium for Children with Frequently Relapsing or Steroid Dependent Nephrotic Syndrome

Kanika Kapoor1, Abhijeet Saha, Manpreet Kaur

  • 1Department of Pediatrics, PGIMER and Dr Ram Manohar Lohia Hospital; and #Department of Biostatics, AIIMS; New Delhi, India. drabhijeetsaha@yahoo.com.

Indian Pediatrics
|November 10, 2017
PubMed

Insights

Enteric coated mycophenolate sodium (ECMS) effectively reduced relapses in children with frequently-relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome (SDNS). This steroid-sparing agent demonstrated significant efficacy and safety in managing these challenging pediatric kidney conditions.

Area of Science:

  • Pediatric Nephrology
  • Immunosuppressive Therapy

Background:

  • Idiopathic frequently-relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome (SDNS) present significant management challenges in children.
  • Steroid-sparing agents are crucial for reducing long-term steroid toxicity in these conditions.

Purpose of the Study:

  • To evaluate the efficacy and safety of enteric coated mycophenolate sodium (ECMS) as a steroid-sparing agent in pediatric patients with FRNS/SDNS.
  • To determine the response rates to ECMS in this patient population over a 6-month period.

Main Methods:

  • Retrospective analysis of 40 pediatric patients (27 FRNS, 13 SDNS) treated with ECMS for at least 6 months.
  • Primary outcome: response to ECMS defined by relapse frequency (complete: 0 relapses, partial: 1 relapse, no response: ≥2 relapses within 6 months).
  • Mean ECMS dose: 985.24 (190.82) mg/m²/day.

Main Results:

  • A significant majority of patients responded to ECMS: 75% (30/40) achieved complete response, and 20% (8/40) had a partial response within 6 months.
  • Only 5% (2/40) of patients did not respond to ECMS during the study period.
  • The treatment was generally well-tolerated, indicating a favorable safety profile.

Conclusions:

  • Enteric coated mycophenolate sodium (ECMS) is a safe and effective steroid-sparing agent for children diagnosed with FRNS and SDNS.
  • ECMS demonstrates a high rate of complete and partial responses, significantly reducing relapse frequency in this pediatric cohort.
  • The findings support the use of ECMS in the management of difficult-to-treat nephrotic syndromes in children.

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