Background Levamisole has been shown to have a steroid-sparing effect in children with steroid-sensitive nephrotic syndrome, but also could produce adverse drug reactions such as reversible neutropenia.

Purpose To determine the effectiveness and safety of a levamisole formulation in capsules used in association with prednisone in the treatment of steroid-dependent nephrotic syndrome (SDNS) in children.

Materials and methods Three-year historical cohort observational retrospective study. We looked for children treated with levamisole from 2008 to 2013 in the database of the Pharmacy Service of our Hospital (Silicon, IANUS). Effectiveness was calculated as a percentage reduction in monthly relapses and as a percentage reduction of prednisone dose comparing treatment with prednisone plus levamisole vs. prednisone alone. Safety was defined as the absence of the following adverse reactions: leukopenia, neutropenia, rash or transaminases increase.

Results We identified 10 patients treated with levamisole during the study period. Median value of percentage reduction in monthly relapses when levamisole was combined was 23%. Median value of percentage dose reduction of prednisone when levamisole was combined was 46%. One patient experienced elevated transaminases during levamisole treatment (10%). Efficacy in reducing prednisone dose was found in 9 out of 10 treatments. Efficacy in reducing relapses was found in 6 out of 10 treatments. 9 out of 10 treatments were safe.

Conclusions Combining levamisole and prednisone could be safe and effective in treating children with SDNS. This treatment appears to reduce relapses of SDNS and doses of prednisone, with a low incidence of adverse effects.

No conflict of interest.