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Abstract: SA-PO588

Induction Therapy With Mycophenolate Mofetil for Steroid-Sensitive Nephrotic Syndrome in Children: A Prospective Single Center Pilot Study

Session Information

  • Pediatric Nephrology - II
    November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1800 Pediatric Nephrology

Authors

  • Mazo, Alexandra, Westchester Medical Center, Valhalla, New York, United States
  • Pereira, Tanya E., Westchester Medical Center, Valhalla, New York, United States
  • Solomon, Sonia, Westchester Medical Center, Valhalla, New York, United States
  • Samsonov, Dmitry V., Westchester Medical Center, Valhalla, New York, United States
Background

Standard induction therapy for steroid sensitive nephrotic syndrome (SSNS) in children is steroids for 12 weeks. The purpose of this study was to evaluate whether Mycophenolate Mofetil (MMF) can replace steroids to complete the induction phase in SSNS.

Methods

Patients 2 to 12 years old with first diagnosis of nephrotic syndrome who achieved remission (UPC < 0.3 mg/mg) within 2 weeks of steroid treatment were recruited. In MMF group (TG) treatment with steroids was stopped on day of enrollment and MMF (1200 mg/m2/day) initiated and continued for a total of 10 wks. Control group (CG) continued standard steroid treatment. Quality of Life (QOL) was assessed by questionnaires at enrollment and in 10 weeks. The primary study outcomes were relapse rate (RR) and relapse free interval (RFI) (time in weeks from enrollment to first relapse). Secondary outcomes included side effects of MMF, steroids, and changes in QOL.

Results

Nine patients were in TG and 17 in CG. During induction phase 2 out of 9 patients (22%) in TG developed relapse compare with 1 out of 17 (6%) in CG (p 0.1). During the first year 6 out of 9 patients (67%) in TG and 12 out of 17 (71%) in CG developed relapse (p 1.0). Median RFI was 11 (QI 5-22) weeks in TG and 17 (QI 13-31) weeks in CG (p 0.7). Two patients in CG and none in TG required treatment for hypertension. QOL improved in both groups, not statistically significant. No difference in secondary outcomes (weight gain, leukopenia, anemia, infection rate) were seen between the groups.

Conclusion

Induction therapy with steroids resulted in less RR during the first 3 months of therapy and prolonged RFI. However, in our small sample data difference between the groups was not statistically significant. Larger randomized study is underway to to compare MMF and steroid induction in SSNS (INTENT study).

Relapse free interval by Kaplan–Meier analysis (logrank test p=0.72)