Efficacy and safety of tacrolimus combined with low-dose glucocorticoids <i>vs.</i> high-dose glucocorticoids in initial treatment of adult-onset minimal change disease: a retrospective cohort study

Background: high-dose glucocorticoids in the treatment of newly diagnosed adult MCD. Methods: renal biopsy at the Second Affiliated Hospital of Xi'an Jiaotong University, China. Patients were divided into two groups: the high-dose glucocorticoids group (GCs group, 39 patients, receiving 1 mg/kg/day prednisone) and the tacrolimus combined with low-dose glucocorticoid group (TAC group, 20 patients, receiving 0.05 mg/kg/day tacrolimus plus 10 mg/day prednisone). Both groups were followed for at least 24 weeks. The primary endpoint was the complete remission rate at 24 weeks, with secondary endpoints including relapse rates. And adverse events was analysed. Results: = 0.045), resolving spontaneously. Longitudinal albumin recovery and estimated glomerular filtration rate (eGFR) stability were similar between groups. Conclusions: Tacrolimus combined with low-dose glucocorticoids demonstrates comparable efficacy to high-dose glucocorticoids in inducing remission for adult-onset MCD, with a more favorable safety profile.