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Levamisole therapy in corticosteroid-dependent nephrotic syndrome
A Bagga1, A Sharma, R N Srivastava
1Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Pediatric Nephrology (Berlin, Germany)
|August 1, 1997
Summary
Prolonged levamisole treatment significantly reduced relapse rates in children with steroid-dependent nephrotic syndrome (SDNS). This therapy demonstrated a steroid-sparing effect, allowing for reduced prednisolone dosage or discontinuation in many patients, with no observed side effects.
Area of Science:
- Pediatric Nephrology
- Clinical Pharmacology
Background:
- Steroid-dependent nephrotic syndrome (SDNS) often requires prolonged immunosuppression.
- Managing SDNS involves balancing efficacy with the side effects of long-term corticosteroid use.
- Alternative or steroid-sparing agents are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of prolonged levamisole treatment in patients with SDNS.
- To assess the steroid-sparing potential of levamisole in this patient population.
- To determine the impact of levamisole on relapse rates.
Main Methods:
- A cohort of 43 patients with SDNS received levamisole (2.5 mg/kg) on alternate days after remission induction with prednisolone.
- Prednisolone dosage was gradually tapered during levamisole therapy.
- Relapse rates before and during levamisole treatment were compared.
Main Results:
- Levamisole treatment significantly reduced the mean relapse rate from 3.0 to 0.9 relapses/year (P < 0.001).
- Prednisolone was discontinued in 18 patients and reduced in 21 others.
- No adverse side effects were reported during levamisole therapy.
- Previous cyclophosphamide treatment did not significantly alter levamisole response.
Conclusions:
- Prolonged levamisole therapy is a safe and effective treatment for SDNS.
- Levamisole exhibits a significant steroid-sparing effect, enabling reduced corticosteroid dependence.
- A substantial number of SDNS patients can maintain remission with levamisole monotherapy.