Naureen Akhtar, Tahir Masood Ahmad, Ijaz Aman.
The use of levamisole in frequent relapsers of nephrotic syndrome.
Pak Paed J Jan ;29(4):189-92.

Objective: To determine the efficacy of levamisole in maintaining long-term remission in frequent relapsers of nephrotic syndrome. Study design: A case control study. Subject and methods: 100 children were selected from Mayo hospital Lahore in the Department of Pediatrics, from January to December, 2002, and were allocated into 2 groups, each group comprising of 50 patients. The study group was given levamisole while the control group received steroids only. The trial agent was considered effective when it was possible to reduce the maintenance dose of steroids to less than 0.5 mg/kg on alternate days. It was abandoned after a minimum of 2 months if no decrease in proteinuria was apparent. Results: The drug was considered ineffective in 10% of the patients, all of whom required more than 1.0 mg/kg steroids on alternate days to prevent relapses and was then discontinued; 30% of the children developed a relapse after 3 months of cessation of treatment, while 50% of them achieved long-term remission. The remaining 10% were lost to follow-up. On the other hand, 26% of the subjects in the control group maintained long-term remission while 50% relapsed within 3 months of stopping the treatment and 10% went into relapse while the steroids were being tapered. The remaining 14% did not turn up for follow-up. Conclusion: Half of the patients in the study group were found to sustain long-term remission with levamisole as compared to 26% of the children in the control group who received steroids alone.

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