{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:38:07Z","timestamp":1790962687338,"version":"4.1.0"},"reference-count":65,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"Importance<\/jats:title>Cyclophosphamide and calcineurin inhibitors are the most used nonsteroid immunosuppressive medications globally for children with various chronic inflammatory conditions. Their comparative effectiveness remains uncertain, leading to worldwide practice variation. Nephrotic syndrome is the most common kidney disease managed by pediatricians globally and suboptimal treatment is associated with high morbidity.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the comparative effectiveness of cyclophosphamide vs calcineurin inhibitors (tacrolimus or cyclosporine) for childhood nephrotic syndrome relapse prevention.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Using target trial emulation methods, the study team emulated a pragmatic, open-label clinical trial using available data from the Insight Into Nephrotic Syndrome: Investigating Genes, Health, and Therapeutics (INSIGHT) study. INSIGHT is a multicenter, prospective cohort study in the Greater Toronto Area, Canada. Participants included children (1 to 18 years) with steroid-sensitive nephrotic syndrome diagnosed between 1996 and 2019 from the Greater Toronto Area, who initiated cyclophosphamide or a calcineurin inhibitor treatment. Data analysis was performed in 2024.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Incident cyclophosphamide or calcineurin inhibitor treatment. Randomization was emulated by overlap weighting of propensity scores for treatment assignment.<\/jats:p><\/jats:sec>Main Outcomes<\/jats:title>The primary outcome was time to relapse, analyzed by weighted Kaplan-Meier and Cox proportional hazards models. Secondary outcomes included relapse rates, subsequent immunosuppression, kidney function, hypertension, adverse events, and quality of life.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 578 children (median age at diagnosis, 3.7 [IQR, 2.8-6.0] years; 371 male [64%] and 207 female [36%]), 252 initiated cyclophosphamide, 131 initiated calcineurin inhibitors, and 87 sequentially initiated both medications. Baseline characteristics were well balanced after propensity score weighting. During median 5.5-year (quarter 1 to quarter 3, 2.5-9.2) follow-up, there was no significant difference in time to relapse between calcineurin inhibitor vs cyclophosphamide treatment (hazard ratio [HR], 1.25; 95% CI, 0.84-1.87). Relapses were more common after calcineurin inhibitor treatment than cyclophosphamide (85% vs 73%) in the weighted cohorts, but not statistically significant. There were also no significant differences in subsequent relapse rates, nonsteroid immunosuppression use, or kidney function between medications. Calcineurin inhibitor treatment was associated with more hospitalizations (HR, 1.83; 95% CI, 1.14-2.92) and intravenous albumin use (HR, 2.81; 95% CI, 1.65-4.81).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study, there was no evidence of difference in time to relapse after cyclophosphamide and calcineurin inhibitor treatment in children with nephrotic syndrome. Cyclophosphamide treatment is shorter in duration and more accessible globally than calcineurin inhibitors.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapediatrics.2024.5286","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T16:32:26Z","timestamp":1737995546000},"page":"321","source":"Crossref","is-referenced-by-count":9,"title":["Comparative Efficacy of Nonsteroid Immunosuppressive Medications in Childhood Nephrotic Syndrome"],"prefix":"10.1001","volume":"179","author":[{"given":"Cal H.","family":"Robinson","sequence":"first","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"},{"name":"Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nowrin","family":"Aman","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonny","family":"Banh","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefina","family":"Brooke","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Chanchlani","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics, McMaster Children\u2019s Hospital, Hamilton, Ontario, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Cuthbertson","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, The University of Toronto, Ontario, Canada"},{"name":"Sunnybrook Health Sciences Centre Research Institute, Toronto, Ontario, Canada"},{"name":"Department of Critical Care Medicine, Sunnybrook Health Sciences Centres, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaneet","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddy","family":"Fan","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, The University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Langlois","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Paediatrics, Montreal Children\u2019s Hospital, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Levin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Licht","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"},{"name":"Program in Cell Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlene","family":"McKay","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Noone","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Pearl","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"},{"name":"Division of Nephrology, William Osler Health Systems, Brampton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetha","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique","family":"Rowley","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia Wei","family":"Teoh","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovanka","family":"Vasilevska-Ristovska","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Heath","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Division of Biostatistics, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Statistical Science, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rulan S.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Paediatrics, The University of Toronto, Toronto, Ontario, Canada"},{"name":"Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Medicine, Women\u2019s College Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"10141","key":"poi240092r1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S0140-6736(18)30536-1","article-title":"Idiopathic nephrotic syndrome in children.","volume":"392","author":"Noone","year":"2018","journal-title":"Lancet"},{"issue":"1","key":"poi240092r2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-029249","article-title":"Incidence and relapse of idiopathic nephrotic syndrome: meta-analysis.","volume":"148","author":"Veltkamp","year":"2021","journal-title":"Pediatrics"},{"issue":"11","key":"poi240092r3","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1007\/s13312-012-0220-4","article-title":"Disease course in steroid sensitive nephrotic syndrome.","volume":"49","author":"Sinha","year":"2012","journal-title":"Indian Pediatr"},{"issue":"4","key":"poi240092r4","doi-asserted-by":"publisher","first-page":"672","DOI":"10.3109\/0886022X.2015.1010940","article-title":"Long-term prognosis of idiopathic nephrotic syndrome in children.","volume":"37","author":"\u00d6zl\u00fc","year":"2015","journal-title":"Ren Fail"},{"issue":"4","key":"poi240092r5","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/j.ekir.2019.12.015","article-title":"Prediction of short- and long-term outcomes in childhood nephrotic syndrome.","volume":"5","author":"Carter","year":"2019","journal-title":"Kidney Int Rep"},{"issue":"1","key":"poi240092r6","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s00467-020-04684-3","article-title":"Impact of steroids and steroid-sparing agents on quality of life in children with nephrotic syndrome.","volume":"36","author":"Khullar","year":"2021","journal-title":"Pediatr Nephrol"},{"issue":"6","key":"poi240092r7","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1038\/ki.1981.209","article-title":"Primary nephrotic syndrome in children: clinical significance of histopathologic variants of minimal change and of diffuse mesangial hypercellularity. A report of the International Study of Kidney Disease in Children.","volume":"20","year":"1981","journal-title":"Kidney Int"},{"issue":"10","key":"poi240092r8","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.2215\/CJN.00380116","article-title":"Ethnic differences in incidence and outcomes of childhood nephrotic syndrome.","volume":"11","author":"Banh","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4S","key":"poi240092r9","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2021.05.021","article-title":"KDIGO 2021 clinical practice guideline for the management of glomerular diseases.","volume":"100","author":"Rovin","year":"2021","journal-title":"Kidney Int"},{"issue":"3","key":"poi240092r10","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s00467-022-05739-3","article-title":"IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome.","volume":"38","author":"Trautmann","year":"2023","journal-title":"Pediatr Nephrol"},{"issue":"4","key":"poi240092r11","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002290.pub5","article-title":"Non-corticosteroid immunosuppressive medications for steroid-sensitive nephrotic syndrome in children.","volume":"4","author":"Larkins","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"22","key":"poi240092r12","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015927","article-title":"Efficacy and acceptability of immunosuppressive agents for pediatric frequently-relapsing and steroid-dependent nephrotic syndrome: a network meta-analysis of randomized controlled trials.","volume":"98","author":"Tan","year":"2019","journal-title":"Medicine (Baltimore)"},{"issue":"10","key":"poi240092r13","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.2215\/CJN.00110112","article-title":"Two-year follow-up of a prospective clinical trial of cyclosporine for frequently relapsing nephrotic syndrome in children.","volume":"7","author":"Ishikura","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"issue":"5","key":"poi240092r14","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1007\/BF00869823","article-title":"Ciclosporin treatment in children with steroid-dependent nephrotic syndrome.","volume":"4","author":"Kitano","year":"1990","journal-title":"Pediatr Nephrol"},{"issue":"1","key":"poi240092r15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF00856817","article-title":"Comparison of cyclosporin and chlorambucil in the treatment of steroid-dependent idiopathic nephrotic syndrome: a multicentre randomized controlled trial.","volume":"6","author":"Niaudet","year":"1992","journal-title":"Pediatr Nephrol"},{"issue":"3","key":"poi240092r16","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/BF00853209","article-title":"Long-term ciclosporin treatment in children with steroid-dependent nephrotic syndrome.","volume":"7","author":"Tanaka","year":"1993","journal-title":"Pediatr Nephrol"},{"issue":"12","key":"poi240092r17","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.1007\/s00467-013-2546-0","article-title":"Substantial practice variation exists in the management of childhood nephrotic syndrome.","volume":"28","author":"Samuel","year":"2013","journal-title":"Pediatr Nephrol"},{"issue":"6","key":"poi240092r18","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1007\/s00431-021-03958-8","article-title":"Practice variations in the management of childhood nephrotic syndrome in the Netherlands.","volume":"180","author":"Schijvens","year":"2021","journal-title":"Eur J Pediatr"},{"issue":"12","key":"poi240092r19","doi-asserted-by":"publisher","first-page":"2975","DOI":"10.1007\/s00467-022-05639-6","article-title":"Clinical practice guidelines for nephrotic syndrome: consensus is emerging.","volume":"37","author":"Sinha","year":"2022","journal-title":"Pediatr Nephrol"},{"issue":"5","key":"poi240092r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2023.151311","article-title":"Childhood nephrotic syndrome in Africa: epidemiology, treatment trends, and outcomes.","volume":"42","author":"Ademola","year":"2022","journal-title":"Semin Nephrol"},{"issue":"3","key":"poi240092r21","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/1097-0142(20010201)91:3<613::AID-CNCR1042>3.0.CO;2-R","article-title":"High risk of infertility and long term gonadal damage in males treated with high dose cyclophosphamide for sarcoma during childhood.","volume":"91","author":"Kenney","year":"2001","journal-title":"Cancer"},{"issue":"1","key":"poi240092r22","article-title":"Cancer Treatment-related infertility: a critical review of the evidence.","volume":"3","author":"Poorvu","year":"2019","journal-title":"J Natl Cancer Inst Cancer Spectr"},{"issue":"7","key":"poi240092r23","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1007\/s00467-014-2897-1","article-title":"Fertility preservation in patients receiving cyclophosphamide therapy for renal disease.","volume":"30","author":"Gajjar","year":"2015","journal-title":"Pediatr Nephrol"},{"issue":"6","key":"poi240092r24","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.2215\/CJN.08880813","article-title":"Cancer risk after cyclophosphamide treatment in idiopathic membranous nephropathy.","volume":"9","author":"van den Brand","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"issue":"8","key":"poi240092r25","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1007\/s00467-020-04570-y","article-title":"Rituximab versus cyclophosphamide as first steroid-sparing agent in childhood frequently relapsing and steroid-dependent nephrotic syndrome.","volume":"35","author":"Kari","year":"2020","journal-title":"Pediatr Nephrol"},{"issue":"9","key":"poi240092r26","doi-asserted-by":"crossref","first-page":"2759","DOI":"10.1007\/s00467-021-05052-5","article-title":"Oral cyclophosphamide therapy in 100 children with steroid-sensitive nephrotic syndrome: experience from a developing country.","volume":"36","author":"Sandhu","year":"2021","journal-title":"Pediatr Nephrol"},{"issue":"9","key":"poi240092r27","doi-asserted-by":"crossref","first-page":"2555","DOI":"10.1007\/s00467-023-06256-7","article-title":"Pediatric contributions and lessons learned from the NEPTUNE cohort study.","volume":"39","author":"Modi","year":"2024","journal-title":"Pediatr Nephrol"},{"issue":"8","key":"poi240092r28","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/aje\/kwv254","article-title":"Using big data to emulate a target trial when a randomized trial is not available.","volume":"183","author":"Hern\u00e1n","year":"2016","journal-title":"Am J Epidemiol"},{"key":"poi240092r29","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jclinepi.2016.04.014","article-title":"Specifying a target trial prevents immortal time bias and other self-inflicted injuries in observational analyses.","volume":"79","author":"Hern\u00e1n","year":"2016","journal-title":"J Clin Epidemiol"},{"issue":"9","key":"poi240092r30","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/j.cjca.2021.05.012","article-title":"Emulating a randomised controlled trial with observational data: an introduction to the target trial framework.","volume":"37","author":"Kutcher","year":"2021","journal-title":"Can J Cardiol"},{"key":"poi240092r31","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/1471-2369-14-25","article-title":"The rationale and design of Insight into Nephrotic Syndrome: Investigating Genes, Health and Therapeutics (INSIGHT): a prospective cohort study of childhood nephrotic syndrome.","volume":"14","author":"Hussain","year":"2013","journal-title":"BMC Nephrol"},{"issue":"9596","key":"poi240092r32","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"issue":"4","key":"poi240092r33","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.kint.2020.10.047","article-title":"Age- and sex-dependent clinical equations to estimate glomerular filtration rates in children and young adults with chronic kidney disease.","volume":"99","author":"Pierce","year":"2021","journal-title":"Kidney Int"},{"issue":"3","key":"poi240092r35","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-1904","article-title":"Clinical practice guideline for screening and management of high blood pressure in children and adolescents.","volume":"140","author":"Flynn","year":"2017","journal-title":"Pediatrics"},{"issue":"8","key":"poi240092r36","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/00005650-200108000-00006","article-title":"PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations.","volume":"39","author":"Varni","year":"2001","journal-title":"Med Care"},{"issue":"23","key":"poi240092r37","doi-asserted-by":"crossref","first-page":"2417","DOI":"10.1001\/jama.2020.7819","article-title":"Overlap weighting: a propensity score method that mimics attributes of a randomized clinical trial.","volume":"323","author":"Thomas","year":"2020","journal-title":"JAMA"},{"issue":"1","key":"poi240092r38","first-page":"250","article-title":"Addressing extreme propensity scores via the overlap weights.","volume":"188","author":"Li","year":"2019","journal-title":"Am J Epidemiol"},{"key":"poi240092r39","article-title":"Alternative approaches for confounding adjustment in observational studies using weighting based on the propensity score: a primer for practitioners.","author":"Desai","journal-title":"BMJ"},{"issue":"6","key":"poi240092r40","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1080\/03610910902859574","article-title":"Using the standardized difference to compare the prevalence of a binary variable between two groups in observational research.","volume":"38","author":"Austin","year":"2009","journal-title":"Commun Stat Simul Comput"},{"issue":"25","key":"poi240092r41","doi-asserted-by":"crossref","first-page":"3083","DOI":"10.1002\/sim.3697","article-title":"Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples.","volume":"28","author":"Austin","year":"2009","journal-title":"Stat Med"},{"issue":"4","key":"poi240092r43","doi-asserted-by":"crossref","first-page":"268","DOI":"10.7326\/M16-2607","article-title":"Sensitivity analysis in observational research: introducing the e-value.","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann Intern Med"},{"issue":"3","key":"poi240092r45","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1177\/0962280219870836","article-title":"Subgroup balancing propensity score.","volume":"29","author":"Dong","year":"2020","journal-title":"Stat Methods Med Res"},{"issue":"1","key":"poi240092r46","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1093\/ndt\/gfq405","article-title":"Long-term effects of cyclophosphamide therapy in steroid-dependent or frequently relapsing idiopathic nephrotic syndrome.","volume":"26","author":"Cammas","year":"2011","journal-title":"Nephrol Dial Transplant"},{"issue":"6","key":"poi240092r47","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1007\/s00467-011-1830-0","article-title":"Cyclophosphamide in steroid-dependent nephrotic syndrome.","volume":"26","author":"Azib","year":"2011","journal-title":"Pediatr Nephrol"},{"issue":"6","key":"poi240092r48","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1007\/s00467-011-1825-x","article-title":"Long-term follow-up after cyclophosphamide therapy in steroid-dependent nephrotic syndrome.","volume":"26","author":"Zagury","year":"2011","journal-title":"Pediatr Nephrol"},{"issue":"12","key":"poi240092r49","first-page":"1326","article-title":"Cyclosporin versus cyclophosphamide for patients with steroid-dependent and frequently relapsing idiopathic nephrotic syndrome: a multicentre randomized controlled trial.","volume":"8","author":"Ponticelli","year":"1993","journal-title":"Nephrol Dial Transplant"},{"issue":"5","key":"poi240092r50","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1053\/j.ajkd.2008.11.033","article-title":"Efficacy and safety of tacrolimus versus cyclosporine in children with steroid-resistant nephrotic syndrome: a randomized controlled trial.","volume":"53","author":"Choudhry","year":"2009","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"poi240092r51","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1186\/s12882-019-1575-8","article-title":"Efficacy and safety of cyclosporine a for patients with steroid-resistant nephrotic syndrome: a meta-analysis.","volume":"20","author":"Li","year":"2019","journal-title":"BMC Nephrol"},{"issue":"11","key":"poi240092r52","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1007\/s00467-012-2228-3","article-title":"Treatment of tacrolimus or cyclosporine A in children with idiopathic nephrotic syndrome.","volume":"27","author":"Wang","year":"2012","journal-title":"Pediatr Nephrol"},{"issue":"7","key":"poi240092r53","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1093\/ndt\/gfi274","article-title":"Treatment of severe steroid-dependent nephrotic syndrome (SDNS) in children with tacrolimus.","volume":"21","author":"Sinha","year":"2006","journal-title":"Nephrol Dial Transplant"},{"issue":"12","key":"poi240092r54","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.2215\/CJN.06620615","article-title":"AKI in children hospitalized with nephrotic syndrome.","volume":"10","author":"Rheault","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"issue":"12","key":"poi240092r55","doi-asserted-by":"crossref","first-page":"3956","DOI":"10.1093\/ndt\/gfq318","article-title":"Treatment with microemulsified cyclosporine in children with frequently relapsing nephrotic syndrome.","volume":"25","author":"Ishikura","year":"2010","journal-title":"Nephrol Dial Transplant"},{"issue":"1","key":"poi240092r56","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1681\/ASN.2021060794","article-title":"Discovery of autoantibodies targeting nephrin in minimal change disease supports a novel autoimmune etiology.","volume":"33","author":"Watts","year":"2022","journal-title":"J Am Soc Nephrol"},{"issue":"1","key":"poi240092r57","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/phar.2749","article-title":"Tacrolimus in the treatment of childhood nephrotic syndrome: machine learning detects novel biomarkers and predicts efficacy.","volume":"43","author":"Mo","year":"2023","journal-title":"Pharmacotherapy"},{"issue":"5","key":"poi240092r60","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/S1470-2045(16)00086-3","article-title":"Pregnancy after chemotherapy in male and female survivors of childhood cancer treated between 1970 and 1999: a report from the Childhood Cancer Survivor Study cohort.","volume":"17","author":"Chow","year":"2016","journal-title":"Lancet Oncol"},{"issue":"11","key":"poi240092r61","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1002\/1097-0142(19921201)70:11<2703::AID-CNCR2820701123>3.0.CO;2-X","article-title":"Impact of cyclophosphamide on long-term reduction in sperm count in men treated with combination chemotherapy for Ewing and soft tissue sarcomas.","volume":"70","author":"Meistrich","year":"1992","journal-title":"Cancer"},{"issue":"8231","key":"poi240092r62","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/S0140-6736(81)92348-5","article-title":"Gonadal function in boys with steroid-responsive nephrotic syndrome treated with cyclophosphamide for short periods.","volume":"1","author":"Trompeter","year":"1981","journal-title":"Lancet"},{"issue":"11","key":"poi240092r63","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/S1470-2045(14)70408-5","article-title":"Cumulative alkylating agent exposure and semen parameters in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort Study.","volume":"15","author":"Green","year":"2014","journal-title":"Lancet Oncol"},{"issue":"3","key":"poi240092r64","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s004670000523","article-title":"A meta-analysis of cytotoxic treatment for frequently relapsing nephrotic syndrome in children.","volume":"16","author":"Latta","year":"2001","journal-title":"Pediatr Nephrol"},{"issue":"3","key":"poi240092r65","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/S1470-2045(19)30818-6","article-title":"Predicting acute ovarian failure in female survivors of childhood cancer: a cohort study in the Childhood Cancer Survivor Study (CCSS) and the St Jude Lifetime Cohort (SJLIFE).","volume":"21","author":"Clark","year":"2020","journal-title":"Lancet Oncol"},{"key":"poi240092r59","volume-title":"Gonadal Toxicity with Cyclophosphamide","author":"BC Renal GN Committee","year":"2019"},{"key":"poi240092r34","unstructured":"KDIGO CKD Work Group. CKD evaluation and management. Accessed December 13, 2024. https:\/\/kdigo.org\/guidelines\/ckd-evaluation-and-management\/"},{"key":"poi240092r42","unstructured":"Greifer? N. Cobalt: covariate balance tables and plots. Accessed December 13, 2024. https:\/\/ngreifer.github.io\/cobalt"},{"key":"poi240092r44","doi-asserted-by":"crossref","unstructured":"Greifer? N. WeightIt: weighting for covariate balance in observational studies. Accessed December 13, 2024. doi:10.32614\/CRAN.package.WeightIt","DOI":"10.32614\/CRAN.package.WeightIt"},{"key":"poi240092r58","unstructured":"Ontario Ministry of Health. Ontario Drug Benefit (ODB) Formulary\/Comparative Drug Index (CDI) edition 43. Accessed December 13, 2024. https:\/\/www.ontario.ca\/document\/ontario-drug-benefit-odb-formulary-comparative-drug-index-cdi-and-monthly-formulary-0"}],"container-title":["JAMA Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/articlepdf\/2829640\/jamapediatrics_robinson_2025_oi_240092_1739908552.42303.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T16:04:14Z","timestamp":1741017854000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/fullarticle\/2829640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":65,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapediatrics.2024.5286","relation":{},"ISSN":["2168-6203"],"issn-type":[{"value":"2168-6203","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3,1]]}}}