Do you prefer a mycophenolate or tacrolimus based glucocorticoid-sparing regimen for patients with minimal change disease?
Answer from: at Academic Institution
I prefer using CNIs over MMF as a steroid-sparing agent. It is important to note that the mechanism of action of CNIs in glomerular disease is likely not just from its immunomodulatory effects as CNIs can also cause stabilization of the podocyte cytoskeleton Peleg et al., PMID 32152065
For frequently relapsing or Steroid-dependent MCD, the choices are:
Cyclophosphamide
Calcineurin inhibitors
Mycophenolate analogs
Rituximab
Currently, I almost exclusively use rituximab, given its efficacy and safety (and convenience).
In the event of rituximab not being available, CNI's a...