ESPN 53rd Annual Meeting

ESPN 2021


 
COMPARATIVE STUDY ON THE THERAPEUTIC RESPONSE TO DIFFERENT DRUG GROUPS IN PATIENTS WITH CORTICODEPENDENT NEPHROTIC SYNDROME
PEDRO ARANGO SANCHO 1 ELENA CODINA SAMPERA 1 YOLANDA CALZADA BAñOS 1 VíCTOR LóPEZ-BAEZ 1 ANA VINUESA JACA 1 LINA CATHERINE HERNáNDEZ ZúñIGA 1 ÁLVARO MADRID ARIS 1

1- HOSPITAL SANT JOAN DE DéU
 
Introduction:

To study the effectiveness and relapses-free persistence of different treatment groups in 107 patients with corticodependent nephrotic syndrome (CDNS)

Material and methods:

Retrospective study in patients with CDNS (2011-2019) who have received treatment with cyclophosphamide(CF), mycophenolate(MMF), cyclosporine(CyA), rituximab(RTX) and/or ofatumumab(OFA), establishing homogeneous groups based on the number of drugs received and the introduction order, thereby defining 7 groups. In group 1 those with only CF. Group 2a those who received CF+MMF. Group 2b those who received CF+CyA. Group 3 those with 3 drugs, subdivided into 3a(CF, MMF and CyA) and 3b(reversing order of MMF and CyA). Finally, group 4(CF-MMF-CYA-RTX) and group 5(CF-MMF-CYA-RTX-OFA) included monoclonal antibodies. The variables analyzed were age at diagnosis, initial treatment, relapses after last treatment, time without relapses and without treatment since the last immunosuppressant.

Results:

Of the total cohort, 63 patients were included (excluding those who did not the criteria of any groups). The mean age at diagnosis was 3.49 years. The distribution was: 62%(group 1), 17%(2a), 8%(2b), 1.5%(3a), 6.3%(3b), 3.1%(4) and 3.1%(5). The mean free time (years) of relapses was: 3.69 (group 1), 1.33 (group 2a), 3.39 (group 2b), 3.7 (group 3a-b), 4.22 (group 4) and 1.04 (group 5). The percentage of patients without relapses after the last treatment was 70%, 100%(2a-b), 75%(3a-b), 100%, 100%, respectively. Currently, within group 1, 83% are without treatment, 10% in 2a, 80% in 2b, 75% in 3b, 50% in 4 and 5 and none in 3a

Conclusions:

62% of the SNCDs were controlled only with the administration of CF. Of those who received more than one drug, the group that received MMF as a second immunosuppressant had a higher mean relapses-free time than the CyA group (p<0.05)