Deflazacort Versus Prednisolone: Randomized Controlled Trial in Treatment of Children With Idiopathic Nephrotic Syndrome

Singhal, Ravish; Pandit, Sadbhavna; Dhawan, Neeraj

doi:10.5812/ijp.510

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…Six milligrams of deflazacort have approximately the same anti-inflammatory potency as 5 mg of prednisolone or prednisone. There was no difference between deflazacort and PDN in the number achieving remission in the first episode of SSNS in two small RCTs [ 69 , 70 ]. However, fewer children relapsed following deflazacort treatment compared with PDN [ 69 , 71 ].…”

Section: Primary Immunosuppressive Treatment Of Idiopathic Nsmentioning

confidence: 99%

“…There was no difference between deflazacort and PDN in the number achieving remission in the first episode of SSNS in two small RCTs [ 69 , 70 ]. However, fewer children relapsed following deflazacort treatment compared with PDN [ 69 , 71 ]. There is a report of toxic epidermal necrolysis in two children with NS who received deflazacort [ 72 ].…”

Section: Primary Immunosuppressive Treatment Of Idiopathic Nsmentioning

confidence: 99%

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IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome

Trautmann

Boyer²,

Hodson³

et al. 2022

Pediatr Nephrol

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Idiopathic nephrotic syndrome is the most frequent pediatric glomerular disease, affecting from 1.15 to 16.9 per 100,000 children per year globally. It is characterized by massive proteinuria, hypoalbuminemia, and/or concomitant edema. Approximately 85–90% of patients attain complete remission of proteinuria within 4–6 weeks of treatment with glucocorticoids, and therefore, have steroid-sensitive nephrotic syndrome (SSNS). Among those patients who are steroid sensitive, 70–80% will have at least one relapse during follow-up, and up to 50% of these patients will experience frequent relapses or become dependent on glucocorticoids to maintain remission. The dose and duration of steroid treatment to prolong time between relapses remains a subject of much debate, and patients continue to experience a high prevalence of steroid-related morbidity. Various steroid-sparing immunosuppressive drugs have been used in clinical practice; however, there is marked practice variation in the selection of these drugs and timing of their introduction during the course of the disease. Therefore, international evidence-based clinical practice recommendations (CPRs) are needed to guide clinical practice and reduce practice variation. The International Pediatric Nephrology Association (IPNA) convened a team of experts including pediatric nephrologists, an adult nephrologist, and a patient representative to develop comprehensive CPRs on the diagnosis and management of SSNS in children. After performing a systematic literature review on 12 clinically relevant PICO (Patient or Population covered, Intervention, Comparator, Outcome) questions, recommendations were formulated and formally graded at several virtual consensus meetings. New definitions for treatment outcomes to help guide change of therapy and recommendations for important research questions are given.

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Section: Primary Immunosuppressive Treatment Of Idiopathic Nsmentioning

confidence: 99%

Section: Primary Immunosuppressive Treatment Of Idiopathic Nsmentioning

confidence: 99%

IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome

Trautmann

Boyer²,

Hodson³

et al. 2022

Pediatr Nephrol

View full text Add to dashboard Cite

show abstract

“…Deflazacort is derived from prednisolone and has similar glucocorticoid and mineralocorticoid properties. Small studies have shown it may be more effective in maintaining remission and may be associated with less corticosteroid toxicity [ 49 , 50 ]. However, the latest Cochrane meta-analysis shows no increased chance of remission with deflazacort, but concludes that it may reduce the number of relapses by 9–12 months.…”

Section: Which Is the Ideal Corticosteroid To Use?mentioning

confidence: 99%

Optimizing the corticosteroid dose in steroid-sensitive nephrotic syndrome

Christian¹,

Maxted²

2021

Pediatr Nephrol

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The use of corticosteroids in the treatment of steroid-sensitive nephrotic (SSNS) syndrome in children has evolved surprisingly slowly since the ISKDC consensus over 50 years ago. From a move towards longer courses of corticosteroid to treat the first episode in the 1990s and 2000s, more recent large, well-designed randomized controlled trials (RCTs) have unequivocally shown no benefit from an extended course, although doubt remains whether this applies across all age groups. With regard to prevention of relapses, daily ultra-low-dose prednisolone has recently been shown to be more effective than low-dose alternate-day prednisolone. Daily low-dose prednisolone for a week at the time of acute viral infection seems to be effective in the prevention of relapses but the results of a larger RCT are awaited. Recently, corticosteroid dosing to treat relapses has been questioned, with data suggesting lower doses may be as effective. The need for large RCTs to address the question of whether corticosteroid doses can be reduced was the conclusion of the authors of the recent corticosteroid therapy for nephrotic syndrome in children Cochrane update. This review summarizes development in thinking on corticosteroid use in SSNS and makes suggestions for areas that merit further scrutiny.

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“…Deazacort, an oxazoline derivative is suggested to reduce osteoporosis, growth suppression and weight gain. (Singhal et al, 2015). In present study we explored the efcacy and safety of Deazacort in paediatric NS.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Deflazacort in the Treatment Of Paediatric Nephrotic Syndrome

Upadhyay

Negi

Sinha

2020

ijsr

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Nephrotic syndrome, an acute renal disorder mostly affects children but may occur in adults also. It is characterized by generalized swelling, proteinuria, excess albuminuria, low serum albumin and hyperlipidemia. It can be classied as primary, secondary and miscellaneous type. Corticosteroid is the main drug to treat NS but their side effects are bigger challenges. We elucidate the efcacy and safety of Deazacort in paediatric NS.

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Deflazacort Versus Prednisolone: Randomized Controlled Trial in Treatment of Children With Idiopathic Nephrotic Syndrome

Cited by 6 publications

References 10 publications

IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome

IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome

Optimizing the corticosteroid dose in steroid-sensitive nephrotic syndrome

Efficacy and Safety of Deflazacort in the Treatment Of Paediatric Nephrotic Syndrome

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