title: Co-administration of cyclosporine and ketoconazole in idiopathic childhood nephrosis.
abstract: The concomitant use of cyclosporine (CsA) and ketoconazole (keto) in children with nephrotic syndrome (NS) has never been reported in the literature. This retrospective cohort study was conducted to investigate cost saving, safety, and efficacy of co-administration of keto and CsA in children with NS. The study included 186 nephrotic children receiving CsA therapy. Most were steroid dependent or resistant, and the most common pathology was focal segmental glomerulosclerosis (62%). Among our patients, 137 received daily keto therapy (keto group) 50 mg/day in addition to CsA, while 49 received CsA alone (non-keto group). The characteristics of both groups were comparable and the mean (+/-SD) duration of treatment was 22.9 +/- 8.1 months. Co-administration of keto significantly reduced the mean dose of CsA with an overall net cost saving of 37%. It also resulted in a significant improvement of CsA response, more successful steroid withdrawal, and decreased the frequency of renal impairment. Keto was generally well tolerated and safe. We conclude that co-administration of low-dose keto with CsA in children with idiopathic NS is safe, significantly reduces the cost of CsA therapy, and may improve the patient outcome.
authors.affiliation: Urology and Nephrology Center, Mansoura, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: el-Husseini
authors.forename: Fathy
authors.initials: F
authors.lastname: el-Basuony
authors.forename: Ihab
authors.initials: I
authors.lastname: Mahmoud
authors.forename: Ahmed
authors.initials: A
authors.lastname: Donia
authors.forename: Nabil
authors.initials: N
authors.lastname: Hassan
authors.forename: Nagy
authors.initials: N
authors.lastname: Sayed-Ahmad
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sobh
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D016572:Cyclosporine / Q000008:administration & dosage* / Q000191:economics*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000191:economics*; D007654:Ketoconazole / Q000008:administration & dosage* / Q000191:economics*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000191:economics*; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D007654:Ketoconazole