Follow-up study of children with nephrotic syndrome treated with a long- term moderate dose of cyclosporine

Hino, Shinjiro; Takemura, Tamiko; Okada, Minoru; Murakami, Kazuhito; Yagi, Kazuro; Fukushima, Kyohji; Yoshioka, Kazuo

doi:10.1053/ajkd.1998.v31.pm9631836

Cited by 54 publications

(53 citation statements)

References 13 publications

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“…It has been shown that long-term moderate to low-dose CsA according to the TDD protocol is effective and relatively safe for children with SDRNS (Hino et al 1998;Inoue et al 1999;El-Husseini et al 2005). However, CsA nephrotoxicity remains a major problem (Hino et al 1998;Inoue et al 1999;Iijima et al 2002).…”

Section: Discussionmentioning

confidence: 99%

“…However, continuous moderate to highdose administration of predonisolone (PDN) to maintain clinical remission is often associated with serious adverse effects (Ruth et al 2005). In this context, cyclosporine A (CsA) has been reported to be an effective steroid-sparing agent for patients with SDRNS, and has been commonly administered twice daily (TDD protocol) under trough blood level monitoring (C 0 ) (Hino et al 1998;Inoue et al 1999;Kano et al 1999;El-Husseini et al 2005).…”

mentioning

confidence: 99%

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Benefits of Once-Daily Administration of Cyclosporine A for Children with Steroid-Dependent, Relapsing Nephrotic Syndrome

Suzuki

Oki

Tsuruga

et al. 2010

Tohoku J. Exp. Med.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Benefits of Once-Daily Administration of Cyclosporine A for Children with Steroid-Dependent, Relapsing Nephrotic Syndrome

Suzuki

Oki

Tsuruga

et al. 2010

Tohoku J. Exp. Med.

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“…Cyclosporine nephrotoxicity was detected in only 8.6% of patients who underwent renal biopsy after 2 years of treatment. Nevertheless, an important limitation of this treatment is cyclosporine dependency, namely the frequent relapse of nephrosis after discontinuation (9)(10)(11)(12). Most studies of relapse after cyclosporine to date have been retrospective, however, and no prospective evaluation in these patients has been reported.…”

Section: Introductionmentioning

confidence: 99%

Two-Year Follow-Up of a Prospective Clinical Trial of Cyclosporine for Frequently Relapsing Nephrotic Syndrome in Children

Ishikura¹,

Yoshikawa

Nakazato

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Although the safety and efficacy of cyclosporine in children with frequently relapsing nephrotic syndrome (FRNS) have been confirmed, no prospective follow-up data on relapse after cyclosporine have appeared. This study is a prospective follow-up trial after 2-year treatment with cyclosporine to investigate cyclosporine dependency after its discontinuation.Design, setting, participants, & measurements Participants who had undergone 2-year protocol treatment with microemulsified cyclosporine for FRNS between January 2000 and December 2005 were followed for an additional 2 years. The primary end point was relapse-free survival after the complete discontinuation of cyclosporine, and the secondary end point was regression-free survival (time to regression to FRNS).Results After exclusion of 7 patients who showed regression to FRNS during the 2-year treatment period, 49 children (median age, 6.5 years) were followed, and classified as children without (n=32; group A) and with (n=17; group B) relapse during the initial cyclosporine treatment. Overall, relapse-free survival probability at 24 months after cyclosporine discontinuation was 15.3% and regression to FRNS-free survival probability was 40.8%. By group, the probability of relapse-free survival was significantly higher in group A (17.9%) than in group B (8.3%) (P,0.001).Conclusions Children with FRNS who receive cyclosporine are at high risk of relapse after discontinuation, particularly those who experience relapse during cyclosporine treatment.

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“…It has been shown that long-term moderateto low-dose twice-daily CsA dosing protocol to maintain trough blood levels of the drug at around 100 ng/ml (the conventional protocol) is effective and relatively safe for the management of children with NS (Hino et al 1998;Kano et al 1999). However, CsA nephrotoxicity remains a major problem (Habib and Niaudet 1994;Inoue et al 1999;Iijima et al 2002).…”

Section: Discussionmentioning

confidence: 99%

“…The definition and criteria used for the diagnosis of steroid-dependent NS (SDNS) and steroid-resistant NS (SRNS), as also for remission and relapse of these conditions, were the same as those described by the International Study of Kidney Disease in Children (Hino et al 1998;Kano et al 1999).…”

Section: Patientsmentioning

confidence: 99%

Renal Biopsy Findings in Children Receiving Long-Term Treatment with Cyclosporine A Given as a Single Daily Dose

Tanaka

Tsugawa

Suzuki

et al. 2006

Tohoku J. Exp. Med.

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Follow-up study of children with nephrotic syndrome treated with a long- term moderate dose of cyclosporine

Cited by 54 publications

References 13 publications

Benefits of Once-Daily Administration of Cyclosporine A for Children with Steroid-Dependent, Relapsing Nephrotic Syndrome

Benefits of Once-Daily Administration of Cyclosporine A for Children with Steroid-Dependent, Relapsing Nephrotic Syndrome

Two-Year Follow-Up of a Prospective Clinical Trial of Cyclosporine for Frequently Relapsing Nephrotic Syndrome in Children

Renal Biopsy Findings in Children Receiving Long-Term Treatment with Cyclosporine A Given as a Single Daily Dose

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