Corticosteroids Vs. Corticosteroids Plus Cycloporin A in Adult Minimal Changes Disease

Overview

Journal BMC Res Notes

Publisher Biomed Central

Specialties Biology
General Medicine

Date 2009 Jul 24

PMID 19624825

Authors

Dimitrios S Goumenos

Pantelitsa Kalliakmani

Eirini Savvidaki

John G Vlachojannis

Affiliations

Soon will be listed here.

Abstract

Background: Adult minimal changes disease (MCD) is usually treated by high corticosteroids dose in order to achieve remission of nephrotic syndrome. In this study, the administration of high steroid dose (prednisolone 1 mg/kg BW/day) is compared with the combination of lower prednisolone dose (0.3 mg/kg BW/day) and cyclosporine A (CsA) (2-3 mg/kg BW/day) in a small number of patients.

Findings: Eighteen patients were allocated to either prednisolone monotherapy or prednisolone and CsA combination, according to the risk of developing steroid side-effects. Complete remission of the nephrotic syndrome was observed in all patients treated by steroids or combination of steroids and CsA. Complete remission occurred in 67%, 89% and 100% of patients after 4, 8 and 12 weeks of treatment. Relapses occurred in 50% of patients from both groups, treated with the combination of low prednisolone dose and CsA and followed by sustained remission. Corticosteroidal side effects were observed only in high prednisolone dose (accumulated dose: 92.7 +/- 22 mg/kg/BW vs. 58.5 +/- 21 mg/kg/BW, p = 0.004).

Conclusion: Treatment of adult MCD with low prednisolone dose and CsA seems to be equally effective with high prednisolone dose to induce remission of nephrotic syndrome. It is also effective as maintenance therapy for prevention of relapses and less frequently followed by corticosteroidal side effects.

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