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. 1985 Nov 9;291(6505):1305–1308. doi: 10.1136/bmj.291.6505.1305

Controlled trial of methylprednisolone pulses and low dose oral prednisone for the minimal change nephrotic syndrome.

E Imbasciati, R Gusmano, A Edefonti, P Zucchelli, C Pozzi, C Grassi, M Della Volpe, F Perfumo, P Petrone, M Picca, et al.
PMCID: PMC1417455  PMID: 3933645

Abstract

In a multicentre, randomised, prospective trial 89 patients (67 children and 22 adults) with the minimal change nephrotic syndrome were treated with three intravenous pulses of methylprednisolone followed by low dose oral prednisone for six months (group given methylprednisolone) or with high dose oral prednisone for four weeks followed by low dose oral prednisone for five months (control group). Five patients in the group given methylprednisolone and one in the control group did not respond initially. The time to response was shorter in children treated with methylprednisolone. No significant differences between the two groups were observed in the number of patients who relapsed or number of relapses per patient per year. Patients given methylprednisolone tended to relapse earlier than patients in the control group. Side effects related to treatment were significantly fewer in the group given methylprednisolone than in the control group. These data suggest that a short course of methylprednisolone pulses followed by low dose oral prednisone is only marginally less effective than a regimen of high dose oral steroids but can improve the ratio of risk to benefit associated with treatment of the minimal change nephrotic syndrome.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bolton W. K., Couser W. G. Intravenous pulse methylprednisolone therapy of acute crescentic rapidly progressive glomerulonephritis. Am J Med. 1979 Mar;66(3):495–502. doi: 10.1016/0002-9343(79)91081-7. [DOI] [PubMed] [Google Scholar]
  2. Cameron J. S., Turner D. R., Ogg C. S., Sharpstone P., Brown C. B. The nephrotic syndrome in adults with 'minimal change' glomerular lesions. Q J Med. 1974 Jul;43(171):461–488. [PubMed] [Google Scholar]
  3. De Vecchi A., Montagnino G., Pozzi C., Tarantino A., Locatelli F., Ponticelli C. Intravenous methylprednisolone pulse therapy in essential mixed cryoglobulinemia nephropathy. Clin Nephrol. 1983 May;19(5):221–227. [PubMed] [Google Scholar]
  4. Grupe W. E. Relapsing nephrotic syndrome in childhood. Kidney Int. 1979 Jul;16(1):75–85. doi: 10.1038/ki.1979.104. [DOI] [PubMed] [Google Scholar]
  5. Kimberly R. P., Lockshin M. D., Sherman R. L., McDougal J. S., Inman R. D., Christian C. L. High-dose intravenous methylprednisolone pulse therapy in systemic lupus erythematosus. Am J Med. 1981 Apr;70(4):817–824. doi: 10.1016/0002-9343(81)90538-6. [DOI] [PubMed] [Google Scholar]
  6. Koskimies O., Vilska J., Rapola J., Hallman N. Long-term outcome of primary nephrotic syndrome. Arch Dis Child. 1982 Jul;57(7):544–548. doi: 10.1136/adc.57.7.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Nash M. A., Bakare M. A., D'Agati V., Pirani C. L. Late development of chronic renal failure in steroid-responsive nephrotic syndrome. J Pediatr. 1982 Sep;101(3):411–414. doi: 10.1016/s0022-3476(82)80072-3. [DOI] [PubMed] [Google Scholar]
  8. Nolasco F., Cameron J. S., Hicks J., Ogg C. S., Williams D. G. Adult-onset nephrotic syndrome with minimal changes: response to corticosteroids and cyclophosphamide. Proc Eur Dial Transplant Assoc Eur Ren Assoc. 1985;21:588–593. [PubMed] [Google Scholar]
  9. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Ponticelli C., Imbasciati E., Case N., Zucchelli P., Cagnoli L., Pasquali S. Intravenous methylprednisolone in minimal change nephrotic syndrome. Br Med J. 1980 Mar 8;280(6215):685–685. doi: 10.1136/bmj.280.6215.685. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ponticelli C., Zucchelli P., Banfi G., Cagnoli L., Scalia P., Pasquali S., Imbasciati E. Treatment of diffuse proliferative lupus nephritis by intravenous high-dose methylprednisolone. Q J Med. 1982;51(201):16–24. [PubMed] [Google Scholar]
  12. Ponticelli C., Zucchelli P., Imbasciati E., Cagnoli L., Pozzi C., Passerini P., Grassi C., Limido D., Pasquali S., Volpini T. Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy. N Engl J Med. 1984 Apr 12;310(15):946–950. doi: 10.1056/NEJM198404123101503. [DOI] [PubMed] [Google Scholar]
  13. White R. H., Glasgow E. F., Mills R. J. Clinicopathological study of nephrotic syndrome in childhood. Lancet. 1970 Jun 27;1(7661):1353–1359. doi: 10.1016/s0140-6736(70)91268-7. [DOI] [PubMed] [Google Scholar]

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