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学科主题: 临床医学
题名:
Efficacy and safety of leflunomide in treatment of steroid-dependent and steroid-resistant adult onset minimal change disease
作者: Zhou, Junhua; Zhang, Yimiao; Liu, Gang; Li, Jun; Xu, Rong; Huang, Jing
关键词: leflunomide ; minimal change disease ; nephrotic syndrome ; steroid-dependent ; steroid-resistant
刊名: CLINICAL NEPHROLOGY
发表日期: 2013-08-01
DOI: 10.5414/CN107723
卷: 80, 期:2, 页:121-129
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: CHANGE NEPHROTIC SYNDROME ; MYCOPHENOLATE-MOFETIL ; RITUXIMAB THERAPY ; CYCLOSPORINE ; NEPHROPATHY ; TRIAL
英文摘要:

Objective: To observe the efficacy and safety of leflunomide combined with prednisone therapy (LEF therapy) in the treatment of patients with adult onset steroid-dependent and steroid-resistant minimal change disease (MCD). Methods: 16 MCD patients who had been treated with LEF therapy were retrospectively analyzed. 87.5% (14/16) of the patients were steroid-dependent and 12.5% (2/16) of the patients were steroid-resistant. The initial dose of LEF was 10 - 20 mg/day combined with prednisone 0.25 - 1.0 mg/kg/day, gradually tapering after 8 weeks. Clinical and laboratory data at baseline, 2nd, 4th, 8th, 12th, 24th, and 48th week were analyzed compared with initial course of prednisone monotherapy (FRED monotherapy) and cyclophosphamide combined with prednisone therapy (CTX therapy). Results: All the 16 patients achieved different levels of remission in LEF therapy. 93.8% (15/16) of the patients, including the two steroid-resistant patients, achieved complete remission. During the treatment, 8 patients had adverse effects which could be well tolerated. Compared LEF therapy with PRED monotherapy (n = 16), the dose of prednisone to maintain remission was reduced (from median 22.5 mg/day to median 7.5 mg/day, p = 0.041); relapse rate during the follow-up decreased from 100% to 31.3% (p = 0.002); the median time before relapse increased from 20.3 weeks to 32.5 weeks. Compared LEF therapy with CTX therapy (n = 12), the dose of prednisone to maintain remission was reduced significantly (from median 22.5 mg/day to median 5.0 mg/day, p = 0.003); relapse rate during the follow-up decreased from 100% to 31.3% (p = 0.001); the median time before relapse increased from 11.7 weeks to 32.5 weeks. Conclusions: LEF therapy seems to be effective in steroid-resistant and steroid-dependent MCD. This therapy may reduce the amount of preclnisone to maintain remission and reduce the relapse rate compared with PRED monotherapy and CTX therapy. LEF therapy was usually well tolerated.

语种: 英语
所属项目编号: 985-2-033-39 ; IRT0803
项目资助者: Project 985 ; Program for Changjiang Scholars and Innovative Research Team in University
WOS记录号: WOS:000323990000006
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/60971
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: Peking Univ, Hosp 1, Minist Hlth China, Renal Div,Dept Med,Inst Nephrol,Key Lab Renal Dis, Beijing 100034, Peoples R China

Recommended Citation:
Zhou, Junhua,Zhang, Yimiao,Liu, Gang,et al. Efficacy and safety of leflunomide in treatment of steroid-dependent and steroid-resistant adult onset minimal change disease[J]. CLINICAL NEPHROLOGY,2013,80(2):121-129.
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