Abstract: FR-PO0666
Intravenous vs. Oral Cyclophosphamide for Minimal Change Disease in Children: A Systematic Review and Meta-Analysis
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - ANCA/FSGS
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Amin, Fahad, King Edward Medical University, Lahore, Punjab, Pakistan
- Kuraku, Dileep Raja, Vinnic'kij nacional'nij medicnij universitet imeni Mikoli Pirogova, Vinnytsia, Vinnytsia Oblast, Ukraine
- Farrukh, Aminah, King Edward Medical University, Lahore, Punjab, Pakistan
- Ali, Maneha, King Edward Medical University, Lahore, Punjab, Pakistan
- Javed, Irtaza, King Edward Medical University, Lahore, Punjab, Pakistan
- Keshapogu, Nagarjuna, Vinnic'kij nacional'nij medicnij universitet imeni Mikoli Pirogova, Vinnytsia, Vinnytsia Oblast, Ukraine
- Zahra, Fatima Tu, King Edward Medical University, Lahore, Punjab, Pakistan
- Shah, Mokshit Mehul, GMERS Medical College, Patan, Gujarat, India
- Cheruvugattu, Nitin Sharma, Our Lady of Fatima University, Valenzuela, NCR, Philippines
- Patel, Puspendra, Cornwall Regional Hospital, Montego Bay, St. James Parish, Jamaica
- Attaluri, Durga Manaswini, Sri Aurobindo Institute of Medical Sciences, Indore, MP, India
- Zain, Jwahira, King Edward Medical University, Lahore, Punjab, Pakistan
- Vijayarao, Sree Sindhu, University of Miami Miller School of Medicine, Miami, Florida, United States
Background
Cyclophosphamide remains a common steroid-sparing option in difficult paediatric minimal change disease, but whether intravenous cyclophosphamide (IVCP) offers an advantage over oral cyclophosphamide (OCP) is still uncertain. A systematic review and meta-analysis were conducted to compare IVCP and OCP in children with minimal change disease
Methods
A systemic search identified studies comparing intravenous vs. oral cyclophosphamide in children with minimal change disease. Six studies met inclusion criteria, comprising a total sample of 366 patients. Outcomes included remission rate, sustained remission, time to remission, infections, alopecia, leukopenia, nausea and vomiting, steroid sensitivity, renal function, relapse, serum albumin and death.
Results
Five studies met the inclusion criteria, encompassing a total of 316 patients. Of these, 144 patients received intravenous cyclophosphamide (IVCP) and 172 patients received oral cyclophosphamide (OCP). IVCP significantly reduced adverse effects compared to OCP, with lower rates of alopecia (OR = 0.49, 95% CI 0.24–0.99, P = 0.05) and leukopenia (OR = 0.20, 95% CI 0.05–0.88, P = 0.03), with no heterogeneity (I2 = 0%). However, there was no statistically significant difference between the groups in remission rate (OR 1.25, 95% CI 0.53–2.95), sustained remission (OR 1.02, 95% CI 0.52–2.03), time to remission (MD 21.40, 95% CI -10.56 to 53.35; I2=93.6%). Infection risk was similar between groups (OR 0.30, 95% CI 0.03–3.44; I2=77.1%), as were nausea and vomiting (OR 2.16, 95% CI 0.30–15.42), renal function (MD 0.01, 95% CI -0.06 to 0.07), and death (OR 0.28, 95% CI 0.03–2.79).
Conclusion
Across the available evidence, IVCP did not show superior efficacy to OCP for remission-related outcomes in children with minimal change disease. Its clearest advantage was a lower risk of alopecia and leukopenia. IVCP may therefore be a reasonable alternative when toxicity profile is a major consideration, although the evidence base remains limited and heterogeneous for several endpoints.