Ehren, Rasmus, Benz, Marcus R., Doetsch, Jorg, Fichtner, Alexander, Gellermann, Jutta, Haffner, Dieter, Hocker, Britta, Hoyer, Peter F., Kaestner, Baerbel, Kemper, Markus J., Konrad, Martin, Luntz, Steffen, Querfeld, Uwe, Sander, Anja, Toenshoff, Burkhard and Weber, Lutz T. (2018). Initial treatment of steroid-sensitive idiopathic nephrotic syndrome in children with mycophenolate mofetil versus prednisone: protocol for a randomised, controlled, multicentre trial (INTENT study). BMJ Open, 8 (10). LONDON: BMJ PUBLISHING GROUP. ISSN 2044-6055

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Abstract

Introduction Idiopathic nephrotic syndrome is the most common glomerular disease in childhood with an incidence of 1.8 cases per 100 000 children in Germany. The treatment of the first episode implies two aspects: induction of remission and sustainment of remission. The recent Kidney Disease Improving Global Outcomes, American Academy of Pediatrics and German guidelines for the initial treatment of the first episode of a nephrotic syndrome recommend a 12-week course of prednisone. Despite being effective, this treatment is associated with pronounced glucocorticoid-associated toxicity due to highdose prednisone administration over a prolonged period of time. The aim of the INTENT study (Initial treatment of steroid-sensitive idiopathic nephrotic syndrom in children with mycophenolate mofetil versus prednisone: protocol for a randomised, controlled, multicentre trial) is to show that an alternative treatment regimen with mycophenolic acid is not inferior regarding sustainment of remission, but with lower toxicity compared with treatment with glucocorticoids only. Methods and design The study is designed as an open, randomised, controlled, multicentre trial. 340 children with a first episode of steroid-sensitive nephrotic syndrome and who achieved remission by a standard prednisone regimen will be enrolled in the trial and randomised to one of two treatment arms. The standard care group will be treated with prednisone for a total of 12 weeks; in the experimental group the treatment is switched to mycophenolate mofetil, also for a total of 12 weeks in treatment duration. The primary endpoint is the occurrence of a treated relapse within 24 months after completion of initial treatment. Ethics and dissemination Ethics approval for this trial was granted by the ethics committee of the Medical Faculty of the University of Heidelberg (AFmu-554/2014). The study results will be published in accordance with the Consolidated Standards of Reporting Trials statement and the Standard Protocol Items: Recommendations for Interventional Trials guidelines. Our findings will be submitted to major international paediatric nephrology and general paediatric conferences and submitted for publication in a peer-reviewed, open-access journal.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Ehren, RasmusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benz, Marcus R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doetsch, JorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fichtner, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gellermann, JuttaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haffner, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hocker, BrittaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoyer, Peter F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaestner, BaerbelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kemper, Markus J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Konrad, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luntz, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Querfeld, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sander, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Toenshoff, BurkhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, Lutz T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-169959
DOI: 10.1136/bmjopen-2018-024882
Journal or Publication Title: BMJ Open
Volume: 8
Number: 10
Date: 2018
Publisher: BMJ PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 2044-6055
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CYCLOSPORINE-A; CARDIOVASCULAR RISK; THERAPY; LONGMultiple languages
Medicine, General & InternalMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/16995

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