{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:47:49Z","timestamp":1781650069628,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,6]],"date-time":"2022-08-06T00:00:00Z","timestamp":1659744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The comparative safety and efficacy of maintenance mycophenolate mofetil (MMF) and cyclosporine (CYC) following rituximab (RTX) in children with steroid\u2010resistance nephrotic syndrome are uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and setting<\/jats:title><jats:p>Multicenter randomized controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Sixty\u2010six children between 2 and 6 years of age with SRNS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Patients were randomized to receive either MMF 1000\u2009mg\/m<jats:sup>2<\/jats:sup>\/day (<jats:italic>n<\/jats:italic>\u00a0=\u00a032) or CYC 5\u00a0mg\/kg\/day (<jats:italic>n<\/jats:italic>\u00a0=\u00a034) for 12\u00a0months following RTX induction therapy (375\u2009mg\/m<jats:sup>2<\/jats:sup>) given as needed for B\u2010cell count.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcomes<\/jats:title><jats:p>Complete remission and adverse events (AEs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Complete remission was observed in 26 patients (83.1%) in the MMF group compared with 21 patients (61.7%) in the CYC group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). The median time to remission was shorter in the MMF group than in the CYC group (2.64 vs. 3.4\u2009months; hazard ratio [HR], 0.61; 95% CI, 0.74\u20130.90, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03). The median time to first relapse was longer in the MMF group compared with the CYC group (10.8 vs. 8.0\u2009months; HR, 1.12; 95% CI, 1.31\u20131.54, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01), and this was significantly correlated with the median time to B\u2010cell recovery in the two groups (8.6 vs. 5.2\u2009months in MMF and CYC, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). The overall incidence of adverse drug events was lower in the MMF group compared with the CYC group (59.3% vs. 76.4%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MMF\u2010RTX is superior to CYC\u2010RTX in maintaining remission with fewer AEs in children with initial SRNS. Additional high\u2010quality randomized control trials with long\u2010term follow\u2010up are needed to identify the long\u2010term potential complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2721","type":"journal-article","created":{"date-parts":[[2022,7,23]],"date-time":"2022-07-23T02:49:23Z","timestamp":1658544563000},"page":"690-696","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Randomized controlled trial to compare safety and efficacy of mycophenolate vs. cyclosporine after rituximab in children with steroid\u2010resistant nephrotic syndrome"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5202-036X","authenticated-orcid":false,"given":"Farahnak","family":"Assadi","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics Rush University Medical Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojgan","family":"Mazaheri","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Pediatrics Semnan University of Medical Science  Semnan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simin","family":"Sadeghi\u2010Bodj","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Pediatrics Zahedan University of Medical Sciences  Zahedan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-020-04519-1"},{"key":"e_1_2_11_3_1","first-page":"S140","article-title":"Steroid\u2010resistant nephrotic syndrome in children","volume":"2","author":"Kidney Disease Improving Global Outcome (KDIGO)","year":"2021","journal-title":"Kidney Int Suppl"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-012-2228-3"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-009-1375-7"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2008.24"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc063706"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.09.021"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.01.008"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-014-2765-z"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-018-4145-6"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/105294199277860"},{"key":"e_1_2_11_13_1","unstructured":"Randomisation and Online Databases for Clinical Trials. 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