In vitro sensitivity to methyl-prednisolone is associated with clinical response in pediatric idiopathic nephrotic syndrome

E. Cuzzoni, S. De Iudicibus, G. Stocco, D. Favretto, M. Pelin, G. Messina, L. Ghio, E. Monti, A. Pasini, G. Montini, G. Decorti, the Nefrokid Group

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Abstract

The aim of this study was to evaluate the in vitro steroid sensitivity as a predictor of clinical response to glucocorticoids in childhood idiopathic nephrotic syndrome (INS). Seventy-four patients (median age 4.33, interquartile range [IQR] 2.82–7.23; 63.5% male) were enrolled in a prospective multicenter study: in vitro steroid inhibition of patients' peripheral blood mononuclear cell proliferation was evaluated by [methyl-3H] thymidine incorporation assay at disease onset (T0) and after 4 weeks (T4) of treatment. Steroid dependence was associated with increased in vitro sensitivity at T4 assessed both as drug concentration inducing 50% of inhibition (IC50; odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.24–0.85; P = 0.0094) and maximum inhibition at the highest drug concentration (Imax; OR = 1.13, 95% CI = 1.02–1.31; P = 0.017). IC50 > 4.4 nM and Imax < 92% at T4 were good predictors for optimal clinical response. These results suggest that this test may be useful for predicting the response to glucocorticoid therapy in pediatric INS.

Original languageEnglish
Pages (from-to)268-274
Number of pages7
JournalClinical Pharmacology and Therapeutics
Volume100
Issue number3
DOIs
Publication statusPublished - 2016

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ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Cuzzoni, E., De Iudicibus, S., Stocco, G., Favretto, D., Pelin, M., Messina, G., Ghio, L., Monti, E., Pasini, A., Montini, G., Decorti, G., & the Nefrokid Group (2016). In vitro sensitivity to methyl-prednisolone is associated with clinical response in pediatric idiopathic nephrotic syndrome. Clinical Pharmacology and Therapeutics, 100(3), 268-274. https://doi.org/10.1002/cpt.372