Evidence map›Paper›PMID 39316153›Full record

ArticlePediatric nephrology (Berlin, Germany)2025

Steroid pulse therapy in idiopathic nephrotic syndrome in the era of modern immunosuppressive treatment-still up to date?

Cyrielle Parmentier, Solene Victor, Claire Dossier, Jean Daniel Delbet, Julien Hogan, Antoine Mouche, Olivia Boyer, Tim Ulinski

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Cyrielle ParmentierPediatric Nephrology Unit - Trousseau Hospital-APHP, ORIGYNE and Sorbonne University-Paris, 26 Av du Docteur Arnold Netter, 75012, Paris, France.
Solene VictorPediatric Nephrology Unit - Trousseau Hospital-APHP, ORIGYNE and Sorbonne University-Paris, 26 Av du Docteur Arnold Netter, 75012, Paris, France.
Claire DossierPediatric Nephrology Unit - Robert Debré Hospital-APHP, University-Paris Cité, Paris, France.
Jean Daniel DelbetPediatric Nephrology Unit - Trousseau Hospital-APHP, ORIGYNE and Sorbonne University-Paris, 26 Av du Docteur Arnold Netter, 75012, Paris, France.
Julien HoganPediatric Nephrology Unit - Robert Debré Hospital-APHP, University-Paris Cité, Paris, France.
Antoine MouchePediatric Nephrology Unit - Trousseau Hospital-APHP, ORIGYNE and Sorbonne University-Paris, 26 Av du Docteur Arnold Netter, 75012, Paris, France.
Olivia BoyerPediatric Nephrology Unit - Necker Enfants Malades-APHP, University-Paris Cité, Paris, France.
Tim UlinskiPediatric Nephrology Unit - Trousseau Hospital-APHP, ORIGYNE and Sorbonne University-Paris, 26 Av du Docteur Arnold Netter, 75012, Paris, France. tim.ulinski@aphp.fr.ORCID http://orcid.org/0000-0002-5338-6352

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntravenous steroid pulses (SP) are successfully used for the treatment of patients with idiopathic nephrotic syndrome (INS) resistant to oral prednisone.

methodsWe performed a retrospective analysis of all patients in the three pediatric nephrology centers of the Paris region from 2002 to 2022 who were resistant to a 30-day course of oral prednisone and who received SP for their first INS flare and analyzed their disease course over 4 years.

resultsForty-seven patients (17 girls), median age 3.4 years, were analyzed. Of them, 68% reached remission within 7 days of SP. No significant short-term side effects were noted. Half of the patients started immunosuppressive treatment immediately after their first remission and 62% of them relapsed at least once, whereas all the patients who did not receive immunosuppressive treatment since their first remission relapsed. Among the SP-sensitive patients, 75% needed calcineurin inhibitor (CNI) or B-cell depletion during their disease course to achieve stable remission. Forty-two percent of the whole cohort received B-cell-depleting agents. Among the 15 SP-resistant patients, all received CNI. Twelve/fifteen patients reached remission. After 4 years, 68% among the SP-sensitive patients and 87% of SP-resistant patients still had an active disease.

conclusionsSP are helpful to obtain rapid remission in pediatric INS patients resistant to oral steroids. However, as most SP-sensitive patients need immunosuppressive drugs, mainly CNI and B-cell-depleting agents it could be interesting to discuss the possibility to start CNI directly after the 30-day course of prednisone instead of SP.

Indexed as

Immunosuppressive AgentsNephrotic SyndromeRemission InductionAdolescentCalcineurin InhibitorsChildChild, PreschoolDrug ResistanceFemaleGlucocorticoidsHumansInfantMaleParisPrednisonePulse Therapy, DrugCalcineurin InhibitorsGlucocorticoidsImmunosuppressive AgentsPrednisoneB-cell depletionCalcineurin inhibitors (CNI)Idiopathic nephrotic syndrome (INS)ImmunosuppressionLong-term disease activitySteroid pulses

Identifiers

PMID39316153

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.