Rituximab Failed to Improve Nephrotic Syndrome in Renal Transplant Patients With Recurrent Focal Segmental Glomerulosclerosis

Yabu, Julie M.; Ho, B. M.; Scandling, John D.; Vincenti, Flavio

doi:10.1111/j.1600-6143.2007.02021.x

Cited by 100 publications

(74 citation statements)

References 22 publications

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“…Nevertheless, some of these patients were treated with rituximab because of the development of lymphoproliferative disorders (5,6), introducing the doubt of a possible pathogenic relationship between such hematologic disorder and the pathogenesis of proteinuria. Conversely, two other recent reports, also of six patients (four adults, two children) communicated a failure of rituximab to improve nephrotic syndrome in renal transplant patients with recurrent FSGS (22,23).…”

Section: Discussionmentioning

confidence: 99%

Rituximab Treatment of Adult Patients with Steroid-Resistant Focal Segmental Glomerulosclerosis

Fernández‐Fresnedo

Segarra

González

et al. 2009

Clinical Journal of the American Society of Nephrology

107

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Background and objectives: Isolated case reports have shown a beneficial effect of rituximab on pediatric patients with primary FSGS, but there is no information about rituximab treatment of FSGS in adults.Design, setting, participants, & measurements: All patients who had biopsy-proven FSGS and were treated with rituximab in Spain were identified, independent of their positive or negative response, among the nephrology departments that belong to the Spanish Group for the Study of Glomerular Diseases (GLOSEN). Their characteristics and outcome after rituximab treatment were studied.Results: Eight patients were identified. Rituximab failed to improve nephrotic syndrome in five of eight patients, who continued to show massive proteinuria and exhibited a rapidly deteriorating renal function in two cases. Among the remaining three patients, two of them showed an improvement of renal function and a remarkable proteinuria reduction and one experienced a beneficial but transitory effect after rituximab. There were no differences in clinical or laboratory characteristics or in the CD20 B lymphocyte count after rituximab between these three patients and the five who had a negative response. The only difference was in the regimen of rituximab administration: Whereas the five patients with a negative response received only four weekly consecutive infusions of 375 mg/m 2 , the three remaining patients received additional doses of rituximab.Conclusions: Only a minority (three of eight) of patients in our series of adult patients with FSGS showed a positive influence of rituximab. More studies are necessary to characterize further the optimal dosages and the mechanisms of action of rituximab in FSGS.

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Section: Discussionmentioning

confidence: 99%

Rituximab Treatment of Adult Patients with Steroid-Resistant Focal Segmental Glomerulosclerosis

Fernández‐Fresnedo

Segarra

González

et al. 2009

Clinical Journal of the American Society of Nephrology

107

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“…Since the year 2000, numerous case reports and small studies of the efficacy of rituximab in treating FSGS have been published [62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78]. The larger case series are summarized in Table 3.…”

Section: Treatmentmentioning

confidence: 99%

Recurrent focal segmental glomerulosclerosis after kidney transplantation

2015

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Focal segmental glomerulosclerosis (FSGS) is an important cause of glomerular disease in children and adolescents and nearly 50 % of affected patients will progress to endstage kidney disease over a 5 to 10-year period. Unfortunately, there is no established treatment for disease in the native kidney. Moreover, up to 55 % of patients develop recurrent disease after receiving a kidney transplant, with a substantially higher risk in patients who have already experienced recurrent disease in a prior transplant. A number of clinical and laboratory factors have been identified as risk factors for this complication. In addition, new investigations into podocyte biology and circulating permeability factors have shed light on the cause of recurrent the disease. While a number of novel therapeutic agents have been applied in the management of this problem, there still is no proven treatment. In this review, we summarize recent advances in the epidemiology, pathophysiology, and treatment of recurrent FSGS in pediatric patients who have received a kidney transplant.

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“…In this case, we believe that management was started sufficiently early and aggressively in order to prevent any negative outcome for her new transplanted kidney. The benefit of Rituximab has been suggested in multiple case series and case reports [10][11][12][13][14][15][16][17][18][19]. The number of doses given varies in different studies between 1-6 doses, with an overall success rate of up to 64%.…”

Section: Discussionmentioning

confidence: 99%

Ablative Therapy in 2016 for Small Renal Masses

Sriprasad¹

2017

UNOAJ

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Rituximab Failed to Improve Nephrotic Syndrome in Renal Transplant Patients With Recurrent Focal Segmental Glomerulosclerosis

Cited by 100 publications

References 22 publications

Rituximab Treatment of Adult Patients with Steroid-Resistant Focal Segmental Glomerulosclerosis

Rituximab Treatment of Adult Patients with Steroid-Resistant Focal Segmental Glomerulosclerosis

Recurrent focal segmental glomerulosclerosis after kidney transplantation

Ablative Therapy in 2016 for Small Renal Masses

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