Single-dose and split-dose prednisolone regimens demonstrate comparable remission efficacy in children with SSNS. Divided dosing may shorten remission by 1-2 days during relapse episodes, but this small benefit must be weighed against the greater HPA-axis suppression observed with multi-dose schedules. Given the heterogeneity and small sample sizes of available trials, the current evidence remains insufficient to establish superiority. Larger multicenter RCTs with standardized protocols and longer follow-up are needed to provide more definitive guidance.
Romano et al. (Sat,) studied this question.