A Cochrane review included 3 RCTs involving a total of 68 participants. Only one study contained all treatment comparisons. No significant difference was found between prednisone compared with placebo for complete (RR 1.44, CI 0.95 to 2.19) and partial remission (RR 1.00, CI 0.07 to 14.45) of the nephrotic syndrome due to minimal change disease. There was no difference between intravenous plus oral steroid treatment versus oral steroids alone for complete remission (RR 0.74, CI 0.50 to 1.08). Prednisone was more efficacious than short-course i.v. methylprednisolone for complete remission (RR 4.95, CI 1.15 to 21.26). No RCTs were identified comparing regimens in adults with a steroid-dependent or relapsing disease course or comparing treatments comprising alkylating agents, cyclosporine, tacrolimus, levamisole, or mycophenolate mofetil.
Comment: The quality of evidence is downgraded by study quality (inadequate methodology or information), by inconsistency (heterogeneity in interventions), and by imprecise results (few patients and wide confidence intervals).