WITHDRAWN: Efficacy and Safety of Mycophenolate Mofetil Versus Levamisole in Children and Adolescents With Idiopathic Nephrotic Syndrome: Results of a Randomized Clinical Trial

Cyclophosphamide and rituximab in frequently relapsing/steroid-dependent nephrotic syndrome

“…The response to rituximab in our centre with regards to time to relapse is similar to that in other recent reports in children with FRSDNS of 6 -18 months [6,[9][10][11]13]. The response to cyclophosphamide recorded here is also well within the range of reports in the literature [14] and is comparable to the efficacy of levamisole and MMF with a recently reported median relapse free interval of approximately 7-8 months [15].…”

Experience with second line drugs in frequently relapsing and steroid dependent childhood nephrotic syndrome in a large Saudi center

“…They include Levamisole, Cyclophosphamide, Mycophenolate Mofetil, Cyclosporine, Tacrolimus, and Rituximab. Several retrospective as well as prospective studies have been conducted on the use of these second line drugs [6], [7], [8], [9], [10], [11], [12]. On review of literature, there was no study so far on the comparison of the 4 second line drugs used in our study with each other.…”

“…With Levamisole, no side effects were seen. With MMF, diarrhea was seen in 7% which resolved after stopping drug temporarily [10].…”

Maintenance of steroid-free remission in nephrotic syndrome

“…Basu et al report that only a minority of their cohort (30 of 112 patients [27%]) did not experience a relapse during the treatment year and many patients still required prednisone at the end of this period. 4 The overall rate of relapse during treatment was higher than expected and greater than that observed in comparable studies. This finding might be related to risk factors for relapses such as young age and long duration of disease as well as inclusion of patients with SDNS and the timing of prednisone withdrawal.…”

“…2 Now, a prospective, open-label trial by Basu et al has shown MMF to be more effective than levamisole in maintaining remission and limiting cumulative prednisone exposure in 112 children and adolescents with idiopathic nephrotic syndrome. 4 These researchers should be commended for conducting a randomized clinical trial in this patient group. They randomly assigned participants with FRNS (n = 64) or SDNS (n = 48) to 12 months of treatment with MMF (1,200 mg/m 2 daily in two doses) or levamisole (2.5 mg/kg on alternate days) while tapering the oral prednisone dose.…”