More than half of adult MCD patients will have a relapse during their lifetime, and up to one in four will become a frequent relapser, experiencing more than three episodes per year. In general, children and adults who go into remission quickly—sometimes within the first week of treatment—are less likely to have subsequent relapses. Because long-term use of steroids has numerous adverse effects, patients with relapsing disease are often prescribed alternative immunomodulatory therapies, such as calcineurin inhibitors, mycophenolate mofetil, and cyclophosphamide.