Abstract
A multicenter prospective study conducted in four university hospitals in Korea investigated the efficacy and tolerance of cyclosporine A (CyA, Sandimmun®) in 30 patients with adult nephrotic syndrome [25 patients with minimal change disease (MCD) and 5 with focal-segmental glomerulosclerosis (FSGS)]. After a 6-week washout period, CyA 5 mg/kg/day and prednisolone 10 mg/day were administered for up to 8 months, depending on responses to CyA. The rate of relapse after withdrawal of CyA was assessed up to 10 months. Of the 30 patients enrolled, 3 withdrew prematurely due to adverse events. Of the 27 patients who completed the study, 22 had MCD and 5 had FSGS. The prior steroid responses of these patients were 19 steroid-dependent (SD), 4 frequent-relapser (FR) and 4 steroid-resistant (SR) type. High rates of complete remission were obtained after CyA treatment in both MCD and FSGS patients, 86.4% (19/22) and 80% (4/5) respectively. Previous steroid responses did not affect the response to CyA; complete remission was obtained in 84.2% (16/19) of SD patients and in 75% (3/4) of SR patients. The mean (± SEM) duration of CyA treatment to attain complete remission in SD and SR patients was 3.8 (± 0.6) weeks and 10.7 (± 2.7) weeks, respectively (not significantly different). Tapering or withdrawal of CyA was followed by release of nephrotic syndrome in many patients, and the cumulative relapse rates at month 10 were 68.4% (13/19) in MCD patients and 50% (2/4) in FSGS patients. When considered according to prior steroid responses, the relapse rate was 73.3% (11/15) in SD patients and 50% (2/4) in SR patients. In conclusion, CyA is a useful adjunct to steroids in patients with MCD and FSGS, irrespective of steroid responses. However, frequent relapses on tapering or stopping CyA is the main problem which remains to be solved.
| Original language | English |
|---|---|
| Pages (from-to) | 375-381 |
| Number of pages | 7 |
| Journal | Clinical Nephrology |
| Volume | 43 |
| Issue number | 6 |
| Publication status | Published - 1995 Jul 12 |
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All Science Journal Classification (ASJC) codes
- Nephrology
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The efficacy of cyclosporine A in adult nephrotic syndrome with minimal change disease and focal-segmental glomerulosclerosis : A multicenter study in Korea. / Lee, H. Y.; Kim, H. S.; Kang, C. M.; Kim, S. G.; Kim, M. J.
In: Clinical Nephrology, Vol. 43, No. 6, 12.07.1995, p. 375-381.Research output: Contribution to journal › Article
TY - JOUR
T1 - The efficacy of cyclosporine A in adult nephrotic syndrome with minimal change disease and focal-segmental glomerulosclerosis
T2 - A multicenter study in Korea
AU - Lee, H. Y.
AU - Kim, H. S.
AU - Kang, C. M.
AU - Kim, S. G.
AU - Kim, M. J.
PY - 1995/7/12
Y1 - 1995/7/12
N2 - A multicenter prospective study conducted in four university hospitals in Korea investigated the efficacy and tolerance of cyclosporine A (CyA, Sandimmun®) in 30 patients with adult nephrotic syndrome [25 patients with minimal change disease (MCD) and 5 with focal-segmental glomerulosclerosis (FSGS)]. After a 6-week washout period, CyA 5 mg/kg/day and prednisolone 10 mg/day were administered for up to 8 months, depending on responses to CyA. The rate of relapse after withdrawal of CyA was assessed up to 10 months. Of the 30 patients enrolled, 3 withdrew prematurely due to adverse events. Of the 27 patients who completed the study, 22 had MCD and 5 had FSGS. The prior steroid responses of these patients were 19 steroid-dependent (SD), 4 frequent-relapser (FR) and 4 steroid-resistant (SR) type. High rates of complete remission were obtained after CyA treatment in both MCD and FSGS patients, 86.4% (19/22) and 80% (4/5) respectively. Previous steroid responses did not affect the response to CyA; complete remission was obtained in 84.2% (16/19) of SD patients and in 75% (3/4) of SR patients. The mean (± SEM) duration of CyA treatment to attain complete remission in SD and SR patients was 3.8 (± 0.6) weeks and 10.7 (± 2.7) weeks, respectively (not significantly different). Tapering or withdrawal of CyA was followed by release of nephrotic syndrome in many patients, and the cumulative relapse rates at month 10 were 68.4% (13/19) in MCD patients and 50% (2/4) in FSGS patients. When considered according to prior steroid responses, the relapse rate was 73.3% (11/15) in SD patients and 50% (2/4) in SR patients. In conclusion, CyA is a useful adjunct to steroids in patients with MCD and FSGS, irrespective of steroid responses. However, frequent relapses on tapering or stopping CyA is the main problem which remains to be solved.
AB - A multicenter prospective study conducted in four university hospitals in Korea investigated the efficacy and tolerance of cyclosporine A (CyA, Sandimmun®) in 30 patients with adult nephrotic syndrome [25 patients with minimal change disease (MCD) and 5 with focal-segmental glomerulosclerosis (FSGS)]. After a 6-week washout period, CyA 5 mg/kg/day and prednisolone 10 mg/day were administered for up to 8 months, depending on responses to CyA. The rate of relapse after withdrawal of CyA was assessed up to 10 months. Of the 30 patients enrolled, 3 withdrew prematurely due to adverse events. Of the 27 patients who completed the study, 22 had MCD and 5 had FSGS. The prior steroid responses of these patients were 19 steroid-dependent (SD), 4 frequent-relapser (FR) and 4 steroid-resistant (SR) type. High rates of complete remission were obtained after CyA treatment in both MCD and FSGS patients, 86.4% (19/22) and 80% (4/5) respectively. Previous steroid responses did not affect the response to CyA; complete remission was obtained in 84.2% (16/19) of SD patients and in 75% (3/4) of SR patients. The mean (± SEM) duration of CyA treatment to attain complete remission in SD and SR patients was 3.8 (± 0.6) weeks and 10.7 (± 2.7) weeks, respectively (not significantly different). Tapering or withdrawal of CyA was followed by release of nephrotic syndrome in many patients, and the cumulative relapse rates at month 10 were 68.4% (13/19) in MCD patients and 50% (2/4) in FSGS patients. When considered according to prior steroid responses, the relapse rate was 73.3% (11/15) in SD patients and 50% (2/4) in SR patients. In conclusion, CyA is a useful adjunct to steroids in patients with MCD and FSGS, irrespective of steroid responses. However, frequent relapses on tapering or stopping CyA is the main problem which remains to be solved.
UR - http://www.scopus.com/inward/record.url?scp=0029066773&partnerID=8YFLogxK
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M3 - Article
C2 - 7554521
AN - SCOPUS:0029066773
VL - 43
SP - 375
EP - 381
JO - Clinical Nephrology
JF - Clinical Nephrology
SN - 0301-0430
IS - 6
ER -