Extending prednisolone treatment does not reduce relapses in childhood nephrotic syndrome


== Abstract ==

xtabstractProlonged prednisolone treatment for the initial episode of childhood nephrotic syndrome may reduce relapse rate, butwhether this results fromthe increased duration of treatment or a higher cumulative dose remains unclear.We conducted a randomized, double-blind, placebo-controlled trial in 69 hospitals in The Netherlands. We randomly assigned 150 children (9 months to 17 years) presenting with nephrotic syndrome to either 3 months of prednisolone followed by 3 months of placebo ( n=74) or 6 months of prednisolone (n=76), and median follow-up was 47 months. Both groups received equal cumulative doses of prednisolone (approximately 3360 mg/m2). Among the 126 children who started trial medication, relapses occurred in 48 (77%) of 62 patients who received 3 months of prednisolone and 51 (80%) of 64 patients who received 6 months of prednisolone. Frequent relapses, according to international criteria, occurred with similar frequency between groups as well (45% versus 50%). In addition, there were no statistically significant differences between groups with respect to the eventual initiation of prednisolone maintenance and/or other immunosuppressive therapy (50% versus 59%), steroid dependence, or adverse effects. In conclusion, in this trial, extending initial prednisolone treatment from 3 to 6 months without increasing cumulative dose did not bene fit clinical outcome in children with nephrotic syndrome. Previous findings indicating that prolonged treatment regimens reduce relapses most likely resulted from increased cumulative dose rather than the treatment duration. Copyrigh


== Original document ==

The different versions of the original document can be found in:

* [http://dx.doi.org/10.1681/ASN.2012070646 http://dx.doi.org/10.1681/ASN.2012070646]

* [http://dx.doi.org/10.1681/asn.2012070646 http://dx.doi.org/10.1681/asn.2012070646]

* [http://hdl.handle.net/1765/40023 http://hdl.handle.net/1765/40023]

* [http://hdl.handle.net/2066/118421 http://hdl.handle.net/2066/118421]

* [https://europepmc.org/articles/PMC3537218 https://europepmc.org/articles/PMC3537218]

* [https://jasn.asnjournals.org/content/jnephrol/24/1/149.full.pdf https://jasn.asnjournals.org/content/jnephrol/24/1/149.full.pdf]

* [https://research.vumc.nl/en/publications/a8c81bd6-12cc-4fe7-abac-e2ae20639f08 https://research.vumc.nl/en/publications/a8c81bd6-12cc-4fe7-abac-e2ae20639f08]

* [https://syndication.highwire.org/content/doi/10.1681/ASN.2012070646 https://syndication.highwire.org/content/doi/10.1681/ASN.2012070646],
: [http://dx.doi.org/10.1681/asn.2012070646 http://dx.doi.org/10.1681/asn.2012070646]

* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3537218 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3537218],
: [https://repository.ubn.ru.nl/handle/2066/118421 https://repository.ubn.ru.nl/handle/2066/118421],
: [http://europepmc.org/articles/PMC3537218 http://europepmc.org/articles/PMC3537218],
: [https://repub.eur.nl/pub/40023 https://repub.eur.nl/pub/40023],
: [https://www.narcis.nl/publication/RecordID/oai%3Arepub.eur.nl%3A40023 https://www.narcis.nl/publication/RecordID/oai%3Arepub.eur.nl%3A40023],
: [http://europepmc.org/abstract/MED/23274956 http://europepmc.org/abstract/MED/23274956],
: [https://jasn.asnjournals.org/lookup/doi/10.1681/ASN.2012070646 https://jasn.asnjournals.org/lookup/doi/10.1681/ASN.2012070646],
: [https://research.vumc.nl/en/publications/extending-prednisolone-treatment-does-not-reduce-relapses-in-chil https://research.vumc.nl/en/publications/extending-prednisolone-treatment-does-not-reduce-relapses-in-chil],
: [http://pubmed.cn/23274956 http://pubmed.cn/23274956],
: [https://academic.microsoft.com/#/detail/2145601642 https://academic.microsoft.com/#/detail/2145601642]