| Drug |
Advantage |
Problem |
Comment |
| Levamisole cases
|
Low toxicity |
Less effective in severe cases
of steroid dependency.
Availability |
First option for less severe |
| Cyclophosphamide
(chlormabucil) |
Short course may induce long-term remission |
Long-term toxicity, especially infertility |
Seems to be more effective in older and female patients, no repeated courses |
| Mycophenolic acid inhibitors (MPA) |
No nephrotoxicity |
MPA dependency, less effective than calcineurin inhibitors Proportion of patients that reach long-term remission is unclear |
Alternative to calcineurin Therapeutic drug monitoring
may have no impact on steroid resistance |
| Cyclosporine |
Effective in severe steroid-dependency |
Cyclosporine dependency side effects |
Tapering to low doses possible |
| Tacrolimus |
Effective in severe steroid-dependency |
Tacrolimus dependency Long-term side effects unclear |
Tapering to low doses possible |
| Rituximab |
Effective in severe steroid-dependency |
Long-term side effects are unknown |
Proportion of patients with drug free |
