Table 1.

Available treatment regimens and published response rates for the initial episode and infrequent relapse of adult MCD

MedicationRegimenRemission Rates (Complete + Partial)
Initial episode without contraindication to steroids
 PrednisoneDose: 1 mg/kg per day (maximum 80 mg/day) or 2 mg/kg every other day (maxium 120 mg every other day), for a minimum of 4 weeks, and a maximum of 16 wks (as tolerated). After remission, taper over a total period of corticosteroid exposure of at least 24 weeks.80%–90%
Initial episode with contraindication to steroids
 Oral CYC2–2.5 mg/kg per d×8 wk75%
 Cyclosporine3–5 mg/kg per d in divided doses×1–2 yr75%
 Tacrolimus0.05–0.1 mg/kg per d in divided doses×1–2 yrUnknown
Infrequent relapse
 Same as initial medicationSame as initial regimenUnknown—thought to be similar to initial remission rate