Use of enteric coated mycophenolate sodium in adult resistant nephrotic syndrome

Abstract

Introduction: Treatment of patients with resistant/relapsed adult nephrotic syndrome (RNS) caused by glomerulopathies has no consensus therapy.

Objectives: This is a retrospective analysis (RA), performed on 55 patients with RNS treated during one year with enteric coated sodium mycophenolate (EC-MPS) and reduced corticosteroids doses.

Material and methods: Inclusion criteria for this RA were: patients aged ≥ 18 years old, diagnosed with RNS with histologically proven glomerulopathy who had received standard therapy with enalapril and/or losartan and 10 mg per day or 20 mg of prednisone every other day. NS was defined with the following criteria: proteinuria > 3.5 g/day, serum albumin ≤ 3 g/dl, hypercholesterolemia and edema. Treatment consisted of oral EC-MPS in 360 mg tablets, 720 mg bid, together with prednisone 10 mg daily or 20 mg every other day. Effectiveness was assessed as the rate of response in the cohort: complete, partial or absent. Complete response patients: 24 hours proteinuria < 300 mg/day, partial response patients: proteinuria > 300 mg/day and < than 3 g/day, all the rest were considered as non responders.

Results: response was achieved in 40/55 (73%) of patients, 24 (44%) with complete response and 16 (29%) with partial response. No EC-MPS discontinuation has been observed due to adverse events, except for one case of transient interruption of medication for 2 weeks.

Conclusion: EC-MPS as single therapy with minimal doses of corticosteroids as in this RA could be an effective alternative in the treatment of patients with RNS.