{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:45:34Z","timestamp":1747187134679,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,26]],"date-time":"2022-06-26T00:00:00Z","timestamp":1656201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children with frequently relapsing (FR) or steroid dependent (SD) nephrotic syndrome (NS) often develop side effects of corticosteroids. Various steroid\u2010sparing agents are in practice, but only a few studies exist so far which have compared the safety and efficacy of these two commonly used agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We did a retrospective medical records review of children with FRNS or SDNS who had levamisole or mycophenolate mofetil (MMF) as a steroid\u2010sparing agent with a minimum follow\u2010up period of 12\u2009months. The aim was to compare the course of our patients on MMF and levamisole. Our primary objective was to determine the number of children in sustained remission and those with the infrequently relapsing course on levamisole and MMF and, the median time to relapse in months in the two groups. The secondary objective was to compare time to first relapse and number of relapses in FRNS and SDNS group children on MMF and levamisole.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 88 children (34% female) with diagnosis FR\/SDNS (44 each) were included in the study. Thirty\u2010nine patients took levamisole, while 49 received MMF therapy. The median age of presentation at the relapsing course was 4.2\u2009years. The proportion of children with sustained remission or infrequent relapsing (IFR) course on MMF was 73.6%, compared to 48.71% on levamisole (<jats:italic>p<\/jats:italic>\u2010value .015). In addition, the median time to first relapse was 12\u2009months (24, 1.5) and 4.5\u00a0months (24, 1) on respective medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clinical outcome was superior in the MMF group than levamisole, especially in SDNS patients, and also MMF was more efficacious in maintaining sustained remission.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.14067","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T05:39:54Z","timestamp":1653629994000},"page":"758-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical efficacy of mycophenolate mofetil versus levamisole therapy in frequently relapsing and steroid dependent childhood nephrotic syndrome \u2013 A retrospective comparative analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2128-7488","authenticated-orcid":false,"given":"Sonia","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Pediatric Nephrology Fortis Hospital Shalimar Bagh  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suprita","family":"Kalra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Army Hospital Research &amp; Referral  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shubham","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Statistics Max Super Speciality Hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peeyush","family":"Sharma","sequence":"additional","affiliation":[{"name":"Departmentof Urology RG stone hospital  New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,26]]},"reference":[{"issue":"3","key":"e_1_2_7_2_1","first-page":"203","article-title":"Management of steroid sensitive nephrotic syndrome: revised guidelines","volume":"45","author":"Indian Pediatric Nephrology Group, Indian Academy of Pediatrics","year":"2008","journal-title":"Indian Pediatr"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14184-0"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2012.115"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-012-2310-x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002290.pub5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(80)80707-4"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004670050307"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.5114\/ceji.2016.63122"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-017-3616-5"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8060860"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.08.011"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015927"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2003.08.011"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-012-2278-6"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00550206"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-018-3970-y"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012121200"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.08.039"},{"key":"e_1_2_7_20_1","first-page":"43","article-title":"Daily levamisole versus mycophenolate mofetil in patients with frequently relapsing or steroid\u2010dependent nephrotic syndrome: open\u2010label non\u2010inferiority randomized controlled trial","volume":"3","author":"Singh J","year":"2020","journal-title":"Asian J Pediatr Nephrol"},{"issue":"1","key":"e_1_2_7_21_1","first-page":"43","article-title":"Levamisole and mycophenolate mofetil significantly reduce the relapses following cyclosporine a withdrawal in steroid dependent nephrotic syndrome","volume":"4","author":"Abeyagunawardena S","year":"2021","journal-title":"Arch Nephrol Urol"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000258"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.14067","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.14067","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.14067","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T04:41:51Z","timestamp":1692765711000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.14067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,26]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1111\/nep.14067"],"URL":"https:\/\/doi.org\/10.1111\/nep.14067","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"type":"print","value":"1320-5358"},{"type":"electronic","value":"1440-1797"}],"subject":[],"published":{"date-parts":[[2022,6,26]]},"assertion":[{"value":"2022-01-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}