ESPN 51th Annual Meeting

ESPN 2018


 
The efficacy and safety of TAC treating children with nephrotic syndrome
CRISTINA JULIA BLAZQUEZ GOMEZ 1 HAZEL WEBB 2 KJELL TULLUS 2

1- HOSPITAL UNIVERSITARIO CENTRAL DE ASTURIAS
2- GREAT ORMOND STREET HOSPITAL
 
Introduction:

Tacrolimus (TAC) is a common second line treatment for children with idiopathic nephrotic syndrome (NS). The aim of this study was to analyse the efficacy and safety of TAC. 

Material and methods:

In this retrospective study, children with idiopathic NS, who were frequently-relapsing or steroid-dependent (FR/SDNS) or steroid-resistant (SRNS) who received tacrolimus for at least 1 month between June 2007 to January 2018, were included. Exclusion criteria: congenital, infantile and secondary NS.

Results:

110 children (55.5% male) were followed-up for 79.1(50.4) months. 33.6% were SR (age at diagnosis 6.4(4.7) years) and 66.3% were FR/SDNS (age at diagnosis 4.5(3.2) years) who started TAC at a mean age of 7.4(4.7) and 8.7(3.9) years respectively. The mean length of TAC was 24.2(14.3) and 22.5(18.83) months. SRNS. 46.9% achieved complete remission at 12 months, 18.9% partial response, 27.0% no remission and in 5.4% the drug was stopped due to side effects.  In 24.3% weaning was started after being on TAC for a mean of 17.89(6.74) months but 44.4% of them relapsed during the weaning. 13 had stopped TAC: in 7 for being in a complete remission, in 2 because of side effects, and in 4 as Tac was not deemed effective enough. FR/SDNS.6-month relapse-rate decreased from 2.7 ± 1.1 episodes before TAC to 1.0 ± 1.2 six months after starting therapy. 20 had stopped TAC: in 6 for being in complete remission, in 4 because of side effects and in a further 10 of the children TAC was stopped due to lack of enough therapeutic response.

Conclusions:

The long-term response to treatment with TAC seems to be better with 53.8% of the children with SRNS and 30% (p>0.05) of the FR/SDNS still in remission after weaning and stopping the drug. The side effects were similar in both groups: SR (15.4%) and FR/SDNS (20%).