Mycophenolate mofetil for sustained remission in nephrotic syndrome

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Uwe Querfeld, L T Weber

Abstract

The clinical application of mycophenolate mofetil (MMF) has significantly widened beyond the prophylaxis of acute and chronic rejections in solid organ transplantation. MMF has been recognized as an excellent treatment option in many immunologic glomerulopathies. For children with frequently relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS) experiencing steroid toxicity, MMF has been recommended as a steroid-sparing drug. Uncontrolled studies in patients with FRNS and SDSN have shown that many patients can achieve sustained remission of proteinuria with MMF monotherapy. Three randomized controlled trials have similarly demonstrated that MMF is beneficial in these patients, but less effective than the calcineurin inhibitors cyclosporin A or tacrolimus. Some, but not all, patients with steroid-resistant nephrotic syndrome (SRNS) may also respond to MMF, usually given in combination with other drugs, with partial or complete remission. There are important limitations to the interpretation and comparability of these studies including study design, sample size, patient selection, clinical endpoints, carry-over effects, and duration of follow-up. In all studies, MMF had relatively few side effects, no...Continue Reading

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Citations

Jul 31, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Gizem YildizSalih Kavukçu
Jul 12, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Uwe Querfeld, Lutz T Weber
Jul 1, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Shuichiro Fujinaga, Koji Sakuraya
Apr 17, 2020·The Cochrane Database of Systematic Reviews·Nicholas G LarkinsElisabeth M Hodson
Mar 6, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Federica ZottaFrancesco Emma
Mar 29, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Lucie MatratAnne-Laure Sellier-Leclerc
Jun 7, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Rasmus EhrenUNKNOWN German Society for Pediatric Nephrology

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