Optimal Use of Sandimmun® in Nephrotic Syndrome

Meyrier, Alain; Niaudet, Patrick; Brodehl, J

doi:10.1007/978-3-642-77310-5

Cited by 11 publications

(8 citation statements)

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“…The cumulative rate of remission peaked at 6 months. 54,56 Tacrolimus achieved 6-month and 2-year remission rates of 79%-91% and 50%-62% in SD/SR MCD patients as noted above, 46,47 and it may allow for the discontinuation of steroids. Tacrolimus has also shown efficacy in case reports 57 and case series, 18,58,59 with remission rates of 64%-100% in this limited experience.…”

Section: Calcineurin Inhibitorsmentioning

confidence: 81%

“…Pooled data from open trials similarly showed 60% complete and 10% partial remission rates in 146 adults and children with SR/SD MCD. 54 Ponticelli et al 55 randomized 73 patients (11 adults and 62 children) with FR/SD NS (31 patients with MCD and 42 patients with FSGS) to CYC (2.5 mg/ kg per day) for 8 weeks or cyclosporine (5 mg/kg per day) for 9 months followed by a 3-month taper to withdrawal. At 9 months, 64% (18/28) of patients on CYC and 74% (26/35) of patients on cyclosporine maintained remission (P = NS).…”

Section: Calcineurin Inhibitorsmentioning

confidence: 99%

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The Treatment of Minimal Change Disease in Adults

Hogan

Radhakrishnan

2013

Journal of the American Society of Nephrology

134

123

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Minimal change disease (MCD) is the etiology of 10%-25% of cases of nephrotic syndrome in adults. The mainstay of treatment for adult MCD, oral gucocorticoids, is based on two randomized controlled trials and extensive observational data in adults, and this treatment leads to remission in over 80% of cases. Relapses are common, and some patients become steroid-resistant (SR), steroid-dependent (SD), or frequently relapsing (FR). The data guiding the treatment of these patients are limited. Here, we review MCD in adults with particular focus on the evidence for immunosuppressive therapy in these patients.

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Section: Calcineurin Inhibitorsmentioning

confidence: 81%

Section: Calcineurin Inhibitorsmentioning

confidence: 99%

The Treatment of Minimal Change Disease in Adults

Hogan

Radhakrishnan

2013

Journal of the American Society of Nephrology

134

123

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“…This latter study was restricted to MCD and FSGS, which were reported to exhibit a better response to CsA therapy [10]. Furthermore, almost 25% of our studied adults had MPGN and MN, these lesions reported to have an inferior response to CsA [9]. Most previous studies showed that the responsiveness to steroids critically influences the subsequent response to CsA [11,12].…”

Section: Discussionmentioning

confidence: 91%

“…The relatively small number of patients having either MPGN or MN in our series suggest that the majority of these two lesions are secondary to systemic diseases. Meyrier and co-workers found no differences in response to CsA between adults and children [9]. This latter study was restricted to MCD and FSGS, which were reported to exhibit a better response to CsA therapy [10].…”

Section: Discussionmentioning

confidence: 99%

Does cyclosporine achieve a real advantage for treatment of idiopathic nephrotic syndrome in children? A long-term efficacy and safety study

et al. 2007

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“…Patients were classified according to CsA response into complete responder (proteinuria <4 mg/h per m 2 body surface area), partial responder (proteinuria between 4.1 and 40 mg/h per m 2 body surface area) or resistant (proteinuria >40 mg/h per m 2 body surface area after 4 months of CsA therapy) [13]. Renal dysfunction was defined as loss of 50% of renal function, as measured by doubling of the baseline serum creatinine or halving of the creatinine clearance.…”

Section: Methodsmentioning

confidence: 99%

Co-administration of cyclosporine and ketoconazole in idiopathic childhood nephrosis

et al. 2004

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The concomitant use of cyclosporine (CsA) and ketoconazole (keto) in children with nephrotic syndrome (NS) has never been reported in the literature. This retrospective cohort study was conducted to investigate cost saving, safety, and efficacy of co-administration of keto and CsA in children with NS. The study included 186 nephrotic children receiving CsA therapy. Most were steroid dependent or resistant, and the most common pathology was focal segmental glomerulosclerosis (62%). Among our patients, 137 received daily keto therapy (keto group) 50 mg/day in addition to CsA, while 49 received CsA alone (non-keto group). The characteristics of both groups were comparable and the mean (+/-SD) duration of treatment was 22.9 +/- 8.1 months. Co-administration of keto significantly reduced the mean dose of CsA with an overall net cost saving of 37%. It also resulted in a significant improvement of CsA response, more successful steroid withdrawal, and decreased the frequency of renal impairment. Keto was generally well tolerated and safe. We conclude that co-administration of low-dose keto with CsA in children with idiopathic NS is safe, significantly reduces the cost of CsA therapy, and may improve the patient outcome.

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Optimal Use of Sandimmun® in Nephrotic Syndrome

Cited by 11 publications

References 0 publications

The Treatment of Minimal Change Disease in Adults

The Treatment of Minimal Change Disease in Adults

Does cyclosporine achieve a real advantage for treatment of idiopathic nephrotic syndrome in children? A long-term efficacy and safety study

Co-administration of cyclosporine and ketoconazole in idiopathic childhood nephrosis

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