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Abstract: PO1642

Long-Term Effectiveness of Low-Dose Prednisone Treatment in Relapses of Steroid-Sensitive Minimal Change Disease

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Martin Capon, Irene, Hospital Universitario Ramon y Cajal, Madrid, Madrid, Spain
  • Viera, Elizabeth R., Hospital Universitario Ramon y Cajal, Madrid, Madrid, Spain
  • Gutierrez-martinez, Eduardo, Hospital Universitario 12 de Octubre, Madrid, Comunidad de Madrid, Spain
  • Fernandez-Lucas, Milagros, Hospital Universitario Ramon y Cajal, Madrid, Madrid, Spain
  • Villacorta Perez, Javier, Hospital Universitario Ramon y Cajal, Madrid, Madrid, Spain
Background

Treatment of relapses of steroid-sensitive minimal change disease (SMCD) involves administration of high doses of prednisone for several weeks, implying significant pharmacological toxicity. In a previous pilot study, the efficacy of treatment with low doses of prednisone for the treatment of relapses in these patients was demonstrated.

Methods

Retrospective analysis of SMCD relapses treated with low doses of prednisone in two centers, was performed, and the response to treatment, the time to reach remission and the free-time of relapse was studied, comparing it with previous relapses of the same patients treated with standard doses of steroids.

Results

85 relapses in 21 patients with SMCD were analyzed. The median age of patients was 35 years (IQR 18-53), with 62% being male. The mean proteinuria at relapse debut was 5.37 ± 4.11 g/g, serum albumin 2.47 ± 0.94 gr/dL and creatinine 0.86 ± 0.35 mg/dL. Thirty-six relapses (42.3%) were treated with low doses of prednisone (LDP) and compared with 49 previous relapses (57.6%) of the same patients, treated with high doses of prednisone (HDP). The mean initial prednisone dose in relapses treated with LDP and HDP was 0.45 ± 0.1 mg/kg and 1.00 ± 0.3 mg/kg, respectively (p=0.001). The mean cumulative dose of prednisone in relapses treated with LDP and HDP was 1771 ± 1303 mg and 3894 ± 2134 mg respectively (p < 0.001). There were no differences in treatment duration between relapses treated with low and high corticosteroids doses (124 days vs 153 respectively; p=0.2). All patients achieved complete remission after steroid treatment. Mean time to remission was 18.4 days for relapses with LDP and 17.1 days for HDP (p = 0.6). The mean free time to relapse after treatment with low doses was 12.6 months vs 10.9 months for those treated with high doses (p = 0.6).

Conclusion

Among SMCD patients, treatment of relapses with low doses of prednisone (0.5 mg/kg) is effective and safe, allowing to minimize cumulative steroid doses and derived toxicity.