<prompt> A child comes with steroid-resistant nephrotic syndrome secondary to FSGS, not responsive to methylprednisolone. What next should be givenOral cyclophosphamideOral cyclosporineOral mycophenolateIV cyclophosphamide  <response>: The treatment options for steroid-resistant nephrotic syndrome are:Calcineurin inhibitors cyclosporine, TacrolinzusIV or oral cyclophosphamideLevamisolMycophenolatePulse corticosteroidAll above immunosuppressants are used along with corticosteroids Prednisolone or methylprednisolone.Cyclosporine and cyclophosphamide are most commonly used.Despite these options, there is a lack of consensus on first line appropriate therapy for steroid-resistant nephrotic syndrome.According to Indian Journal of pediatric vol. 46, Jan 17, 2009 the efficacy of these drugs are in decreasing order: Tacrolimus Prednisolone cyclosporine Prednisolone IV cyclophosphamide Prednisolone Pulse Corticosteroids IV dexamethasone oral cyclophosphamide Prednisolne oral cyclophosphamide Predniso-lone.So, amongst the given options, best answer is cyclosporine. 