ReviewPediatric nephrology (Berlin, Germany)2005
Levamisole in steroid-sensitive nephrotic syndrome of childhood: the lost paradise?
Review in Pediatric nephrology (Berlin, Germany), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Non-corticosteroid immunosuppressive medications for steroid-sensitive nephrotic syndrome in children.The Cochrane database of systematic reviews · 2024Pooled it
- Non-corticosteroid immunosuppressive medications for steroid-sensitive nephrotic syndrome in children.The Cochrane database of systematic reviews · 2020Pooled it
- Short-term outcome of levamisole in frequently relapsing nephrotic syndrome: a single-center prospective cohort study.Frontiers in nephrology · 2025Article
- Article
- Levamisole and ANCA positivity in childhood nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2021Article
- Levamisole in Children with Idiopathic Nephrotic Syndrome: Clinical Efficacy and Pathophysiological Aspects.Journal of clinical medicine · 2019Review
- Population pharmacokinetics of levamisole in children with steroid-sensitive nephrotic syndrome.British journal of clinical pharmacology · 2015Article
- Pathologic manifestations of levamisole-adulterated cocaine exposure.Diagnostic pathology · 2015Review
- Complications associated with use of levamisole-contaminated cocaine: an emerging public health challenge.Mayo Clinic proceedings · 2012Article
- New therapies in steroid-sensitive and steroid-resistant idiopathic nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2011Review
- Revised guidelines for management of steroid-sensitive nephrotic syndrome.Indian journal of nephrology · 2008Article
- Childhood nephrotic syndrome: change in pattern and response to steroids.Journal of the National Medical Association · 2006Review
- Evidence-based management of steroid-sensitive nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2005Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Among the different drugs used for sparing steroids in steroid-sensitive nephrotic syndrome (SSNS) with frequent relapses and steroid dependency, levamisole is the least toxic and the least expensive. However, it is neither approved for this indication nor widely used in Europe. This may be explained by the difficulty in obtaining levamisole in some countries and the lack of good quality evidence for its effectiveness. Evidence is limited to three clinical trials that all suffered from methodological limitations. Statistical synthesis of these trials showed that levamisole reduces the risk of a relapse during treatment (relative risk 0.60, 95% confidence interval 0.45-0.79). From the available information, no conclusions can be drawn on the steroid-sparing effect, the long-term efficacy, and safety, as well as possible differences in efficacy in different subgroups of SSNS patients. The confirmation of a favorable effect of levamisole on the reduction of the frequency of relapses and on sparing steroids in an adequately powered, double-blind, placebo-controlled, randomized, multi-center clinical trial will promote consensus on the place of levamisole in the treatment of SSNS of childhood. Follow-up should be at least 1 year to evaluate long-term efficacy and side effects. If the results of such a clinical trial confirm the beneficial effects of levamisole in nephrotic syndrome, this may allow registration for this indication and interest companies other than Jansen-Cilag, which only recently has decided to stop its production.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.