Mycophenolate therapy in frequently relapsing minimal change disease that has failed cyclophosphamide therapy

We report 4 consecutive adult patients with steroid-responsive frequently relapsing minimal change disease (MCD) who continued to experience relapse after 1 to 4 courses of cyclophosphamide therapy. Each patient then was administered mycophenolate mofetil (MMF) and prednisone in tapering doses. This therapy was followed by sustained remission and is being well tolerated. MMF is promising therapy in frequently relapsing MCD, even in those with disease that continued to relapse after cyclophosphamide therapy. A controlled clinical trial of MMF therapy in this disorder is warranted.