Do you prefer a mycophenolate or tacrolimus based glucocorticoid-sparing regimen for patients with minimal change disease?

I prefer using CNIs over MMF as a steroid-sparing agent. It is important to note that the mechanism of action of CNIs in glomerular disease is likely not just from its immunomodulatory effects as CNIs can also cause stabilization of the podocyte cytoskeleton Peleg et al., PMID 32152065

For frequently relapsing or Steroid-dependent MCD, the choices are:

• Cyclophosphamide
• Calcineurin inhibitors
• Mycophenolate analogs
• Rituximab

Currently, I almost exclusively use rituximab, given its efficacy and safety (and convenience).

In the event of rituximab not being available, CNI's are my ne...