Kidney Week

Abstract: TH-OR068

Treatment Patterns, Response, and Relapse in Minimal Change Disease: A US Registry Study

Session Information

• Glomerular Diseases: Epidemiology and Real-World Outcomes
  October 22, 2026 | Location: Room 501, Convention Center
  Abstract Time: 05:10 PM - 05:20 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Lewing, Benjamin, Otsuka Pharmaceutical Development and Commercialization Inc, Princeton, New Jersey, United States

Benjamin Lewing, PhD

• Khan, Anam M., RTI Health Solutions, Durham, North Carolina, United States

Anam M. Khan, PhD

• Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States

Margaret Helmuth, MA

• Layton, J. Bradley, RTI Health Solutions, Durham, North Carolina, United States

J. Bradley Layton, PhD

• Dellepiane, Sergio, Otsuka Pharmaceutical Development and Commercialization Inc, Princeton, New Jersey, United States

Sergio Dellepiane, MD, PhD

• Demas, Caroline, University of Michigan, Ann Arbor, Michigan, United States

Caroline Demas, MPH

• Gidey, Saba, Otsuka Pharmaceutical Development and Commercialization Inc, Princeton, New Jersey, United States

Saba Gidey, PharmD

• Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States

Laura H. Mariani, MD, MS, FASN

Background

Minimal change disease (MCD) is a histologic lesion associated with immune-mediated nephrotic syndrome (NS), characterized by frequent relapse. This study describes demographics, clinical characteristics, treatment patterns, and outcomes among participants with MCD.

Methods

Participants aged ≥18 years from the United States with a biopsy showing evidence of MCD were identified in the CureGN Glomerular Disease Registry (2014-2024). The biopsy date was the index date. Participants with evidence of NS before biopsy were included; those with long-term corticosteroid use at the time of biopsy were excluded so that initial treatment response could be observed. Follow-up began the day after biopsy and ended at registry disenrollment, end of available data, or death. Among participants who initiated corticosteroids within 1 year of biopsy and had recorded urine protein-to-creatinine ratio (UPCR) measurements at baseline and ≥1 follow-up measurement within 8 months of initiation, treatment response was classified as complete response (CR; UPCR <0.3 g/g), partial response (PR; UPCR 0.3–3.5 g/g and <50% of baseline), or none. Responders (CR/PR) were followed to evaluate relapse using subsequent UPCR measurements. Times to response and relapse were summarized descriptively.

Results

A total of 77 eligible participants with MCD were identified. At biopsy, median age was 45.0 years, 66% were female, and median (interquartile range [IQR]) estimated glomerular filtration rate was 81.8 (65.7-105.7) mL/min/1.73m². Fifty-two participants initiated corticosteroids within 1 year of biopsy (mean time to initiation, 28 days [standard deviation, 60]); within 12 months of corticosteroid initiation, 56% of participants had added another immunosuppressant. Among corticosteroid initiators, 35 individuals had available UPCR data for response assessment; 88.6% responded (CR, 71.4%; PR, 17.1%), with median (IQR) time to response of 53 days (28-135). Among responders, 43% relapsed within 1 year and 63% within 2 years; median (IQR) time to relapse was 166 days (40-441).

Conclusion

Most participants with MCD initiated corticosteroids soon after biopsy and had high response rates; however, relapse was common and many received additional immunosuppression. Findings highlight the challenges of identifying effective therapy for patients with MCD and emphasize the need for therapies that induce durable remission and reduce relapse.

Funding

• Commercial Support – Otsuka Pharmaceutical Development and Commercialization, Inc.