Prolonged Intermittent Steroid Therapy for Nephrosis in Children and Adults

Lange, Kurt; Wasserman, Edward; Slobody, Lawrence B.

doi:10.1001/jama.1958.03000040013003

Cited by 56 publications

(6 citation statements)

References 2 publications

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“…The results confirm the earlier reports on relapse rates following a prolonged initial steroid treatment [4,12] as well as a recent report [16] in which it was shown that a long-term tapering regimen with a 4 weeks continuous prednisone therapy followed by a 6 month alternate day treatment was more effective than a standard therapy of the initial attack. It remains however unclear whether the benefitial effect of a longer prednisone regimen in these studies was due to the increased cumulative steroid dosage or to the longer duration of immunosuppression during the extended prednisone therapy.…”

Section: Discussionsupporting

confidence: 91%

Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children

1993

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Two regimens of steroid treatment for the initial attack of idiopathic nephrotic syndrome (NS) in children were compared in a controlled prospective multi-centre study. Long prednisone therapy consisted of 60 mg/m2 per 24 h for 6 weeks, followed by alternate day 40 mg/m2 per 48 h for 6 weeks. The standard prednisone therapy was 60 mg/m2 per 24 h for 4 weeks, followed by 40 mg/m2 per 48 h for 4 weeks. A total of 71 children with an initial attack of idiopathic NS were allocated at random to the two groups. The cumulative rate of patients with sustained remissions after 2 years was significantly higher after the long course than after the standard treatment (49% vs 19%, P = 0.0079). The mean relapse rate per patient at intervals of 3, 6 and 12 months was lower in the long-course prednisone group than in the standard prednisone group, and the proportion of children with frequent relapses during any subsequent 6 months period was lower in the long-course group than in the standard group (29% vs 57%, P = 0.03). Mild side-effects of corticosteroid therapy were observed more frequently after long-course prednisone treatment. It is concluded that long-course prednisone therapy of the initial attack of steroid responsive NS is preferable to the standard regimen because it reduces the rate of subsequent relapses without increasing the risk for severe steroidal side-effects.

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Section: Discussionsupporting

confidence: 91%

Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children

1993

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“…Daily Versus Alternate-Day Steroid Therapy Alternate-day corticosteroid regimens for NS were first described in the 1950s, 35 and they have been associated with less adrenal suppression, less effect on growth, and similar efficacy in children. However, no randomized or prospective trials comparing daily with alternate-day dosing have been performed in adults.…”

Section: Efficacymentioning

confidence: 99%

The Treatment of Minimal Change Disease in Adults

Hogan

Radhakrishnan

2013

Journal of the American Society of Nephrology

128

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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“…three days every week) treatment over a period of years. The best known system of this type employed ACTH and cortisone (Lange, Wasserman, and Slobody, 1958); our own is shown in the Table. It is clear that any one of many different systems may be successful with a steroid-sensitive patient. Our own results with patients followed for a minimum of 5 years are shown in Fig.…”

Section: Treatmentmentioning

confidence: 99%

Management of the nephrotic syndrome.

Arneil¹

1968

Archives of Disease in Childhood

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Prolonged Intermittent Steroid Therapy for Nephrosis in Children and Adults

Cited by 56 publications

References 2 publications

Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children

Long versus standard prednisone therapy for initial treatment of idiopathic nephrotic syndrome in children

The Treatment of Minimal Change Disease in Adults

Management of the nephrotic syndrome.

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