Corticosteroid side effects are typically seen in children with frequently relapsing (FR) or steroid-dependent (SD) nephrotic syndrome (NS). There are many steroid-sparing medications in use, but only a few trials have examined the effectiveness and safety of these two widely used drugs.

For a study, researchers examined the medical records of children with FRNS or SDNS who received levamisole or mycophenolate mofetil (MMF) as a steroid-sparing medication and had at least a 12-month follow-up period. The purpose was to contrast how the patients fared on MMF and levamisole. The main research goals were the number of children in persistent remission and those with a seldom relapsing history on levamisole and MMF, as well as the median time to relapse in months in the 2 groups. The secondary goal was to examine the frequency of relapses and the time to first relapse in children in the FRNS and SDNS groups who were on MMF and levamisole.

The research comprised 88 kids (34% of whom were female) diagnosed with FR/SDNS (44 each). Thirty-nine patients received levamisole, while 49 had MMF treatment. At the relapsing course, the median age of presentation was 4.2 years. About 73.6% of children on MMF had prolonged remission or an infrequent relapsing (IFR) course, compared to 48.71% of children on levamisole (P-value .015). The median period between the first relapse and the start of the respective treatments was 12 months (24, 1.5) and 4.5 months (24, 1), respectively.

Particularly among SDNS patients, the clinical result was better in the MMF group than in the levamisole group. In addition, MMF was also more effective in sustaining prolonged remission.

Reference: onlinelibrary.wiley.com/doi/10.1111/nep.14067