Table 3.

Published experience for the treatment of steroid-resistant, SD, and FR MCD in adults

MedicationEvidenceRegimenRemission RatesRelapse Rates
SRaSDFRSRaSDFR
Oral CYCObservational series; one RCT in adults2–2.5 mg/kg per d×8 wk50%–80%50%–80%50%–80%50%25%–56%25%–56%
iv CYCTwo small RCTs in adults750 mg/m2 per mo×6 mo + steroids50%77%NA14%40%NA
Cyclosporine ± prednisoneLarge observational series data; one small RCT in children and one RCT in adults3–5 mg/kg per d in divided dose×1–2 yr45%–92%45%–92%45%–92%NA62%–75%62%–75%
Tacrolimus ± prednisoneSmall observational series; two small RCTs in adults0.05–0.1 mg/kg per d in divided dose×1–2 yr79%–100%91%–100%NA40%50%NA
Mycophenolate mofetilSmall observational series; one small RCT in children1–2 g/d in divided dose25%80%–100%58%NA20%–50%20%–50%
  • In many studies, the outcomes for these groups are combined. NA, data not available; RCT, randomized controlled trial.

  • a In steroid-resistant cases, review of the initial biopsy and a repeat biopsy may be considered to evaluate for FSGS.