{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T09:20:00Z","timestamp":1701940800096},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Exp Nephrol"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Current treatment for frequently relapsing, steroid-dependent, or steroid-resistant nephrotic syndrome focuses on immunosuppressive therapies. Although the clinical guideline suggests the use of mycophenolate mofetil (MMF), limited information is available on patients with primary nephrotic syndrome who receive off-label treatment with MMF in Japan.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>The dose, treatment duration, previous treatment, and characteristics of primary nephrotic syndrome patients receiving MMF were investigated using data from a Japanese hospital claims database (April 2008\u2013September 2021).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Data on 424 primary nephrotic syndrome patients receiving MMF (146 patients\u2009&lt;\u200918\u00a0years old; 278 patients\u2009\u2265\u200918\u00a0years old) were captured. The most common initial daily doses of MMF capsules (% of patients\u2009&lt;\u200918 and\u2009\u2265\u200918\u00a0years old) were 1000\u00a0mg (31.9%, 36.8%), 1500\u00a0mg (16.0%, 23.8%), and 500\u00a0mg (23.6%, 17.3%), and the most common maximum daily doses were 1000\u00a0mg (43.8%, 32.9%), 1500\u00a0mg (23.6%, 28.9%), and 2000\u00a0mg (6.3%, 16.2%). Most patients (97.9%, 99.3%) were treated with a daily dose of 2000\u00a0mg or less. Among patients\u2009&lt;\u200918\u00a0years old, the younger the patient, the lower the dose. MMF was used for more than 1\u00a0year in 30.8% of patients\u2009&lt;\u200918\u00a0years old and in 28.8% of patients\u2009\u2265\u200918\u00a0years old.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our study suggested that off-label use of MMF for primary nephrotic syndrome has increased since 2012 in Japan. The dose of MMF used in patients with primary nephrotic syndrome was generally within the approved dose range for lupus nephritis and transplant-related diseases in Japan.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10157-022-02233-w","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T12:15:35Z","timestamp":1652789735000},"page":"1005-1013","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of mycophenolate mofetil in patients with pediatric and adult primary nephrotic syndrome: information from a Japanese hospital claims database"],"prefix":"10.1007","volume":"26","author":[{"given":"Takashi","family":"Funatogawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Narita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuma","family":"Mii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Sugitani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"2233_CR1","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1038\/s41581-019-0217-5","volume":"15","author":"MA Saleem","year":"2019","unstructured":"Saleem MA. Molecular stratification of idiopathic nephrotic syndrome. Nat Rev Nephrol. 2019;15:750\u201365.","journal-title":"Nat Rev Nephrol"},{"key":"2233_CR2","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1016\/S0140-6736(14)60541-9","volume":"384","author":"K Iijima","year":"2014","unstructured":"Iijima K, Sako M, Nozu K, Mori R, Tuchida N, Kamei K, Miura K, Aya K, Nakanishi K, Ohtomo Y, Takahashi S, Tanaka R, Kaito H, Nakamura H, Ishikura K, Ito S, Ohashi Y, Rituximab for Childhood-onset Refractory Nephrotic Syndrome (RCRNS) Study Group. Rituximab for childhood-onset, complicated, frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome: a multicentre, double-blind, randomised, placebo-controlled trial. 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Kidney Int. 2021;100(4S):S1\u2013S276."},{"key":"2233_CR9","unstructured":"Ishikura K, Maruyama s, Hamada R, Japanese Society for Pediatric Nephrology (Ed.). Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2020. Shindan-to-Chiryo Sha; 2020. [ISBN 978-4-7878-2397-7] (Japanese only)."},{"key":"2233_CR10","unstructured":"Narita I, Okada H, Yasuda Y, Nephrotic Syndrome Guideline Working Group, Study Group on Intractable Kidney Diseases (Ed.). Edence-based clinical practice guideline for nephrotic syndrome 2020, Tokyo-Igakusha; 2020. [ISBN 978-4-88563-726-1] (Japanese only)."},{"key":"2233_CR11","unstructured":"Medical Data Vision Co., Ltd. Accessed at: https:\/\/en.mdv.co.jp\/. Accessed 1 Nov 2021."},{"key":"2233_CR12","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1093\/ndt\/gfaa134","volume":"36","author":"K Shinkawa","year":"2021","unstructured":"Shinkawa K, Yoshida S, Seki T, Yanagita M, Kawakami K. 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The authors have no other relevant conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}