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Grams ME, Sang Y, Ballew SH, et al, for the Chronic Kidney Disease Prognosis Consortium. Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate. Kidney Int. 2018;93:1442–1451

Philippe Remy 1 Vincent Audard 1 Pierre André Natella 2 Gaëlle Pelle 3 Bertrand Dussol 4 Hélène Leray-Moragues 5 Khedidja Bouachi 6 Jacques Dantal 7 Laurence Vrigneaud 8 Alexandre Karras 9 Frank Pourcine 1 Philippe Gatault 10 Philippe Grimbert 1 Nawelle Ait Sahlia 1 Anissa Moktefi 11 Eric Daugas 12 Claire Rigothier 13 Sylvie Bastuji-Garin 14 Dil Sahali 15 Jean Claude Aldigier Pierre Bataille 16 Bernard Canaud 5 Dominique Chauveau 17 Christian Combe 18 Gabriel Choukroun 19 Emilie Cornec-Legall 20 Karine Dahan 21 Michel Delahousse 22 Dominique Desvaux 23 Patrice Deteix 24 Antoine Durrbach 25 Vincent Esnault 26 Marie Essig 27 Patrick Fievet 28 Thierry Frouget 29 Dominique Guerrot 30 Michel Godin 31 Annie Gontiers-Picard Morgane Gosselin Catherine Hanrotel-Saliou 32 Anne-Elisabeth Heng 33 Antoine Huart 17 Antoine Humbert Tomek Kofman 23 Aurélie Hummel 34 Philippe Lang 23 Maurice Laville 35 Yannick Lemeur 20 Paolo Malvezzi 36 Marie Matignon 23 Rafik Mesbah 37 Bruno Moulin 38 Sandrine Muller Jerome Olagne Agathe Pardon 6 François Provôt 39 Guillaume Queffeulou 40 Emmanuelle Plaisier 41 Quentin Raimbourg 42 Philippe Rieu 43 Thomas Stehlé 44 Philippe Vanhille 45 Brad Astor Adeera Levin 46 Mila Tang Ognjenka Djurdjev Sankar Navaneethan Stacey Jolly Jesse Schold Joseph Nally Jonathan Emberson John Townend 47 Martin Landray Harold Feldman Chi-Yuan Hsu James Lash Lawrence Appel Philip Kalra James Ritchie Raman Maharajan Rachel Middleton Donal O’donoghue Markus Schneider 48 Florian Kronenberg 49 Barbara Bärthlein Jamie Green H. Lester Kirchner Kevin Ho 50 Angharad Marks Corri Black Gordon Prescott 51 Nick Fluck Masaaki Nakayama Mariko Miyazaki Tae Yamamoto Gen Yamada Angela Yee-Moon Wang 52 Sharon Cheung Sharon Wong Jessie Chu Henry Wu Amit Garg Eric Mcarthur Danielle Nash Varda Shalev Gabriel Chodick Peter Blankestijn 53 Jack F.M. Wetzels 54 Arjan van Zuilen Jan van den Brand 55 Lesley Inker Mark Sarnak 56 Hocine Tighiouart Haitao Zhang 57 Bénédicte Stengel 58 Marie Metzger 58 Martin Flamant 59 Pascal Houillier 60 Jean-Philippe Haymann 61 Pablo Rios 62 Nelson Mazzuchi Liliana Gadola Verónica Lamadrid Laura Solá 63 John Collins C. Raina Elley Timothy Kenealy Olivier Moranne 64 Cécile Couchoud 65 Cécile Vigneau 29, 66 Nigel Brunskill Rupert Major David Shepherd James Medcalf Csaba Kovesdy Kamyar Kalantar-Zadeh 67 Miklós Molnár 68 Keiichi Sumida Praveen Potukuchi Hiddo J.L. Heerspink Dick de Zeeuw Barry Brenner Juan Jesus Carrero 69 Alessandro Gasparini Abdul Rashid Qureshi Carl-Gustaf Elinder Frank L.J. Visseren Yolanda van der Graaf 70 Marie Evans Maria Stendahl Staffan Schön Mårten Segelmark 71 Karl-Göran Prütz David Naimark Navdeep Tangri Patrick Mark Jamie Traynor Colin Geddes Peter Thomson Alex Chang Ron Gansevoort 72 Anna Köttgen Andrew Levey Luxia Zhang 73 Shoshana Ballew Jingsha Chen Josef Coresh Morgan Grams Lucia Kwak Kunihiro Matsushita Yingying Sang Aditya Surapaneni Mark Woodward 74 Kai-Uwe Eckardt 75 Brenda Hemmelgarn David Wheeler 76 Wolfgang Winkelmayer John Davis Danielle Green Michael Cheung Tanya Green Melissa Mcmahan
1 Service de néphrologie [CHU Henri Mondor]
2 Assistance Publique-Hôpitaux de Paris, Department of Pathology, Centre hospitalier universitaire Henri Mondor, F-94000 Créteil, France
3 Department of Nephrology and Transplantation, Foch Hospital,
4 Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM]
5 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
6 Service de néphrologie et transplantation
7 Institut Transplantation Urologie et Néphrologie
8 Service de Néphrologie [Valenciennes]
9 HEGP - Hôpital Européen Georges Pompidou [APHP]
10 Service de Néphrologie CHU TOURS
11 INSERM U955, équipe 21
Service de néphrologie et transplantation, IMRB - Institut Mondor de Recherche Biomédicale
12 UMR 1599
13 Department of Nephrology, Transplantation and Dialysis, Bordeaux
14 LIC - Laboratoire d'Investigation Clinique
15 Hôpital Henri Mondor
16 UNIL - Université de Lausanne
17 Service de Néphrologie et Immunopathologie Clinique, Centre Hospitalier Universitaire de Toulouse
18 CHU Bordeaux [Bordeaux]
19 Unité Médicale de Soins Intensifs
20 CHU - BREST - Nephrologie - CHRU Brest - Service de Nephrologie
21 Service de Néphrologie et Dialyses [CHU Tenon]
22 Service de transplantation rénale
23 IMRB - Institut Mondor de Recherche Biomédicale
24 Service Néphrologie, Pôle REUNNIRH
25 U542
26 Service de néphrologie
27 Service de Néphrologie, Dialyse, Transplantations [CHU Limoges]
28 UTINAM - Univers, Transport, Interfaces, Nanostructures, Atmosphère et environnement, Molécules (UMR 6213)
29 CHU Pontchaillou [Rennes]
30 Service de Néphrologie [Rouen]
31 EnVI - Nouvelles Cibles Pharmacologiques de la Protection Endothéliale et de l'Insuffisance Cardiaque
32 Service de Néphrologie
33 UNH - Unité de Nutrition Humaine - Clermont Auvergne
34 CHU Necker - Enfants Malades [AP-HP]
35 Service de Néphrologie
36 Service de Néphrologie, Dialyse, Aphérèses et Transplantation [CHU Grenoble]
37 CH Boulogne sur Mer
38 Service de Néphrologie et Transplantation
39 CHU Saint-Antoine [AP-HP]
40 Service de néphrologie
41 Remodelage et Reparation du Tissu Renal
42 Service de Néphrologie [Bichat - Claude Bernard]
43 CHU Reims - Centre Hospitalier Universitaire de Reims
44 UPD5 Médecine - Université Paris Descartes - Faculté de Médecine
45 Service de médecine interne et néphrologie
46 Division of Nephrology [Vancouver, BC, Canada]
47 Aberdeen University
48 Fraunhofer SIT - Fraunhofer Institute for Secure Information Technology [Darmstadt]
49 Division of genetic epidemiology
50 Department of electronic engineering
51 Institute of Applied Health Sciences
52 Department of Medicine
53 Department of Nephrology [Utrecht, Pays-Bas]
54 Department of Nephrology [Nijmegen, The Netherlands]
55 Department of nephrology [Nimègue, Pays-Bas]
56 Tufts Medical Center
57 NUAA - Nanjing University of Aeronautics and Astronautics [Nanjing]
58 CESP - Centre de recherche en épidémiologie et santé des populations
59 Service de Physiologie [Bichat-Claude Bernard]
60 Service de Physiologie [Georges-Pompidou]
61 Des Maladies Rénales Rares aux Maladies Fréquentes, Remodelage et Réparation
62 Center for Research in Agricultural Genomics
63 Directora Division Epidemiologia [Montevideo, Uruguay]
64 Service de néphrologie
65 Agence de la biomédecine [Saint-Denis la Plaine]
66 Irset - Institut de recherche en santé, environnement et travail
67 Division of Nephrology, Department of Medicine
68 MAORE - Méthodes Algorithmes pour l'Ordonnancement et les Réseaux
LIRMM - Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier
69 Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology
70 Julius Center for Health Sciences and Primary Care
71 Division of Drug Research/Clinical Pharmacology, Department of Medicine and Health, Faculty of Health Sciences
72 Department of Nephrology [Groningue, Pays-Bas]
73 Renal Division [Beijing, China]
74 The Georges Institute for International Health
75 Department of Nephrology and Hypertension [Erlangen, Germany]
76 BCM - Baylor College of Medicine
Abstract : First-line therapy of minimal change nephrotic syndrome (MCNS) in adults is extrapolated largely from pediatric studies and consists of high-dose oral corticosteroids. We assessed whether a low corticosteroid dose combined with mycophenolate sodium was superior to a standard oral corticosteroid regimen. We enrolled 116 adults with MCNS in an open-label randomized controlled trial involving 32 French centers. Participants randomly assigned to the test group (n=58) received low-dose prednisone (0.5 mg/kg/day, maximum 40 mg/day) plus enteric-coated mycophenolate sodium 720 mg twice daily for 24 weeks; those who did not achieve complete remission after week 8 were eligible for a second-line regimen (increase in the prednisone dose to 1 mg/kg/day with or without Cyclosporine). Participants randomly assigned to the control group (n=58) received conventional high-dose prednisone (1 mg/kg/day, maximum 80 mg/day) for 24 weeks. The primary endpoint of complete remission after four weeks of treatment was ascertained in 109 participants, with no significant difference between the test and control groups. Secondary outcomes, including remission after 8 and 24 weeks of treatment, did not differ between the two groups. During 52 weeks of follow-up, MCNS relapsed in 15 participants (23.1%) who had achieved the primary outcome. Median time to relapse was similar in the test and control groups (7.1 and 5.1 months, respectively), as was the incidence of serious adverse events. Five participants died from hemorrhage (n=2) or septic shock (n=3), including 2 participants in the test group and 3 in the control group. Thus, in adult patients, treatment with low-dose prednisone plus enteric-coated mycophenolate sodium was not superior to a standard high-dose prednisone regimen to induce complete remission of MCNS.
Keywords : clinical trial idiopathic nephrotic syndrome mycophenolate steroids
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Journal articles
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-02445392
Contributor : Cécile Vigneau <>
Submitted on : Monday, January 20, 2020 - 10:49:26 AM
Last modification on : Wednesday, October 14, 2020 - 4:07:04 AM

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UNIV-RENNES1 | INRA | HCL | UNIV-FCOMTE | CHLS | CESP | IMRB | UPEC-UPEM | UPEC | MAORE | UVSQ | IRSET | LIRMM | IRSET-8 | BIOSIT | UR1-UFR-SVE | INSU | UNIV-PARIS5 | MIPS | UNIV-MONTPELLIER | UNH | UNIV-RENNES | UNIROUEN | UNIV-AMU | SORBONNE-UNIVERSITE | UNIV-PARIS7 | U1155 | UNIV-ANGERS | COMUE-NORMANDIE | USPC | CNRS | PRES_CLERMONT | UNIV-PARIS-SACLAY | SU-MEDECINE | INRAE | UNIV-PARIS

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Philippe Remy, Vincent Audard, Pierre André Natella, Gaëlle Pelle, Bertrand Dussol, et al.. Grams ME, Sang Y, Ballew SH, et al, for the Chronic Kidney Disease Prognosis Consortium. Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate. Kidney Int. 2018;93:1442–1451. Kidney International, Nature Publishing Group, 2018, 94 (5), pp.1025-1026. ⟨10.1016/j.kint.2018.08.009⟩. ⟨hal-02445392⟩

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