The certainty of evidence is downgraded by study limitations.
A Cochrane review «Interventions for minimal change disease in adults with nephrotic syndrome»1 «Azukaitis K, Palmer SC, Strippoli GF et al. Interventions for minimal change disease in adults with nephrotic syndrome. Cochrane Database Syst Rev 2022;(3):CD001537. »1 included 15 studies with a total of 768 subjects. Comparison with prednisolone alone, calcineurin inhibitors (CNIs, like cyclosporine and tacrolimus) with reduced-dose prednisolone or without prednisolone showed little or no difference to the number achieving complete remission (RR 0.99, 95% CI 0.93 to 1.05; 8 trials, n=492), complete or partial remission (RR 1.01, 95% CI 0.96 to 1.05; 4 trials, n=269), or relapse (RR 0.73, 95% CI 0.51 to 1.03; 7 trials, n=422). The comparison of different prednisolone regimens and doses with no specific treatment (4 trials) yielded very low evidence because of very few participants. However, there was a clear and strong trend towards positive effect for complete or partial remission and less relapses with prednisolone.