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Article: Low-dose corticosteroid and mycophenolate for primary treatment of minimal change disease

TitleLow-dose corticosteroid and mycophenolate for primary treatment of minimal change disease
Authors
Issue Date2020
PublisherOxford University Press. The Journal's web site is located at http://qjmed.oxfordjournals.org/
Citation
QJM, 2020, v. 113 n. 6, p. 399-403 How to Cite?
AbstractBackground: 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.
Persistent Identifierhttp://hdl.handle.net/10722/293761
ISSN
2020 Impact Factor: 3.21
2020 SCImago Journal Rankings: 0.427
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMa, MKM-
dc.contributor.authorYap, DYH-
dc.contributor.authorLi, CL-
dc.contributor.authorMok, MMY-
dc.contributor.authorChan, GCW-
dc.contributor.authorKwan, LPY-
dc.contributor.authorLai, KN-
dc.contributor.authorTang, SCW-
dc.date.accessioned2020-11-23T08:21:25Z-
dc.date.available2020-11-23T08:21:25Z-
dc.date.issued2020-
dc.identifier.citationQJM, 2020, v. 113 n. 6, p. 399-403-
dc.identifier.issn1460-2725-
dc.identifier.urihttp://hdl.handle.net/10722/293761-
dc.description.abstractBackground: 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.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://qjmed.oxfordjournals.org/-
dc.relation.ispartofQJM-
dc.rightsPost-print: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in [insert journal title] following peer review. The definitive publisher-authenticated version [insert complete citation information here] is available online at: xxxxxxx [insert URL that the author will receive upon publication here].-
dc.titleLow-dose corticosteroid and mycophenolate for primary treatment of minimal change disease-
dc.typeArticle-
dc.identifier.emailMa, MKM: h9914584@graduate.hku.hk-
dc.identifier.emailYap, DYH: desmondy@hku.hk-
dc.identifier.emailMok, MMY: mmymok@hku.hk-
dc.identifier.emailChan, GCW: gcwchan1@hku.hk-
dc.identifier.emailKwan, LPY: kpy472@hku.hk-
dc.identifier.emailLai, KN: knlai@hku.hk-
dc.identifier.emailTang, SCW: scwtang@hku.hk-
dc.identifier.authorityYap, DYH=rp01607-
dc.identifier.authorityLai, KN=rp00324-
dc.identifier.authorityTang, SCW=rp00480-
dc.identifier.doi10.1093/qjmed/hcz297-
dc.identifier.scopuseid_2-s2.0-85086052097-
dc.identifier.hkuros320061-
dc.identifier.volume113-
dc.identifier.issue6-
dc.identifier.spage399-
dc.identifier.epage403-
dc.identifier.isiWOS:000542077500005-
dc.publisher.placeUnited Kingdom-

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