The use of enteric-coated mycophenolate sodium in the treatment of relapsing and steroid-dependent minimal change disease.

We report on the successful treatment of 5 consecutive adult patients with steroid-dependent or frequently relapsing minimal change disease (MCD), using a regimen of enteric-coated mycophenolate sodium (E-MPS) and prednisolone. E-MPS was used for induction therapy in 3 patients, and maintenance therapy in 2, all in conjunction with steroid treatment in tapering doses. Eventually 4 patients managed to discontinue steroid treatment, and 2 of them were also withdrawn from E-MPS. This combination therapy resulted in sustained remission and was well tolerated by our patients, with no signs of gastrointestinal upset, marrow suppression or increased incidence of infections. Our preliminary experience suggests that E-MPS is a promising new alternative in the management of steroid-dependent and relapsing MCD with a possibility of improving gastrointestinal tolerance.