Low-dose corticosteroid and mycophenolate for primary treatment of minimal change disease
In: QJM : monthly journal of the Association of Physicians, Jg. 113 (2019-07-06), Heft 6
Online
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Zugriff:
Background Mycophenolate has been shown to be effective in glomerular disease. However, the role of mycophenolate in the first-line treatment of adult-onset idiopathic minimal change disease (MCD) has not been systematically studied in a randomized fashion. Aim To evaluate the therapeutic efficacy of enteric-coated mycophenolate sodium combined with low-dose corticosteroid as first-line treatment for MCNS. Design A prospective, open-label, randomized clinical trial. Methods Twenty adult patients with biopsy proven MCD were recruited and randomly assigned to receive either enteric-coated Mycophenolate Sodium (EC-MPS) plus low-dose prednisolone (Group 1: Prednisolone 0.25 mg/kg/day, n = 10) or standard-dose prednisolone (Group 2: Prednisolone 1 mg/kg/day, n = 10). Results After 24 weeks of therapy, eight patients in Group 1 vs. seven of patients in Group 2 achieved complete remission (P = 0.606). Both groups showed a significant reduction of urine protein excretion (P < 0.05) and increased serum albumin (P < 0.001) vs. baseline levels. However, no significant between-group differences were demonstrated. The relapse rate was also similar in both groups. Both treatment regimens were well tolerated but there were more patient reported adverse effects in the standard-dose prednisolone group. Conclusion EC-MPS plus low-dose prednisolone is non-inferior to standard-dose prednisolone therapy in inducing clinical remission and preventing relapse in adult-onset idiopathic MCD and is associated with better tolerability and less adverse effects. This trial is registered with the ClinicalTrials.gov number NCT01185197.
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Low-dose corticosteroid and mycophenolate for primary treatment of minimal change disease
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Autor/in / Beteiligte Person: | Kar Neng Lai ; Lorraine Py Kwan ; Gary Cw Chan ; Yap, Dyh ; Sydney C.W. Tang ; Maggie My Mok ; Ma, Mkm ; C L Li |
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Zeitschrift: | QJM : monthly journal of the Association of Physicians, Jg. 113 (2019-07-06), Heft 6 |
Veröffentlichung: | 2019 |
Medientyp: | unknown |
ISSN: | 1460-2393 (print) |
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