Cyclosporin A is superior to cyclophosphamide in children with steroid-resistant nephrotic syndrome - a randomized controlled multicentre trial by the Arbeitsgemeinschaft fur Padiatrische Nephrologie
Cyclosporin A is superior to cyclophosphamide in children with steroid-resistant nephrotic syndrome - a randomized controlled multicentre trial by the Arbeitsgemeinschaft fur Padiatrische Nephrologie
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DOI：
10.1007/s00467-008-0794-1
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发表时间：
2008-09-01
影响因子：
3
通讯作者：
Rascher, Wolfgang
中科院分区：
文献类型：
--
作者：
Plank, Christian;Kalb, Veronica;Rascher, Wolfgang
First line immunosuppressive treatment in steroid-resistant nephrotic syndrome in children is still open to discussion. We conducted a controlled multicentre randomized open label trial to test the efficacy and safety of cyclosporin A (CSA) versus cyclophosphamide pulses (CPH) in the initial therapy of children with newly diagnosed primary steroid-resistant nephrotic syndrome and histologically proven minimal change disease, focal segmental glomerulosclerosis or mesangial hypercellularity. Patients in the CSA group (n=15) were initially treated with 150 mg/m(2) CSA orally to achieve trough levels of 120-180 ng/ml, while patients in the CPH group (n=17) received CPH pulses (500 mg/m(2) per month intravenous). All patients were on alternate prednisone therapy. Patients with proteinuria > 40 mg/m(2) per hour at 12 weeks of therapy were allocated to a non-responder protocol with high-dose CSA therapy or methylprednisolone pulses. At week 12, nine of the 15 (60%) CSA patients showed at least partial remission, evidences by a reduction of proteinuria < 40 mg/h per m(2). In contrast, three of the 17 (17%) CPH patients responded (p
