Короткий курс стероидов оказался не хуже стандартного при лечении заболеваний почек у взрослых

A short-course corticosteroid taper is noninferior to a standard taper for adult patients with podocytopathies, such as focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD), according to results of an Indian clinical trial published in Kidney International Reports. In the intent-to-treat group, patients who received a short course of oral prednisolone tapered over 2 months showed similar 12-month remission rates to patients who received a standard course tapered over 4 months (63.3% vs 57.8%). The absolute difference in remission rates met the prespecified noninferiority criteria. The difference remained noninferior in the per-protocol analysis, in which the short-course group had a 66.7% remission rate at 12 months, and the standard course had a 68.6% remission rate (1-sided P =.014). “This randomized trial provides evidence that a two-month steroid taper is an effective and potentially safer alternative to prolonged tapering in adults with steroid-sensitive podocytopathy,” the authors said. Regarding safety profiles, adverse events were significantly lower in the short-course group than in the standard-course group (24.5% vs 53.3%; P =.003). This result was consistent with the per-protocol cohorts (24.4% vs 54.3%; P =.006). The standard-course group also experienced higher rates of quality-of-life-limiting issues, including cosmetic changes (15.5% vs. 4.1%) and arthralgia/myalgia (13.3% vs. 2.0%). Noninferiority and lower corticosteroid exposure, with reduced metabolic and symptomatic toxicity, provide strong evidence for a shorter corticosteroid taper. The study included 94 patients with steroid-sensitive podocytopathy, including 46 with FSGS and 48 with MCD, who were randomized to either the short-course arm (n=49) or the standard-course arm (n=45). The median age of participants was 31.9 years, and the study included slightly more males (60.6%) than females (39.4%). The median time to remission after treatment initiation for the overall group was 38 days. This article originally appeared on Rare Disease Advisor References: Prabhahar A, Bharati J, Sharma T, et al. Randomized controlled trial of corticosteroid tapering in steroid-sensitive podocytopathy. Kidney Int Rep. Published online August 5, 2026. doi:10.1016/j.ekir.2026.107004