Rituximab for minimal change disease in adults: long-term follow-up

Abstract

Our study reinforces the role of rituximab as a GC-sparing agent in the challenging GC-dependent and multirelapsing MCD patients. In this emerging therapeutic field randomized studies with extended follow-up will add important information regarding optimal treatment, relapse and safety.

American Society of Nephrology Quiz and Questionnaire 2013

“…The beneficial effect of rituximab was confirmed in two recent studies (26,27). Bruchfeld et al reported the longterm follow-up of 16 patients (9 women, 7 men; aged 19-73 years) with frequent-relapsing, steroid-dependent (prednisone 5 and 20 mg/d), or steroid-resistant MCD treated with rituximab (26).…”

“…Bruchfeld et al reported the longterm follow-up of 16 patients (9 women, 7 men; aged 19-73 years) with frequent-relapsing, steroid-dependent (prednisone 5 and 20 mg/d), or steroid-resistant MCD treated with rituximab (26). Patients had experienced 3 to .20 relapses despite previous immunosuppressive therapy, including cyclophosphamide, calcineurin inhibitors, azathioprine, MMF, chlorambucil, and/or levamisole.…”

“…(3) Should the initial rituximab treatment be given after remission is induced or during a relapse? Some studies suggest that rituximab is more effective when given to patients in remission (22); however, in a study by Bruchfeld et al, the majority of patients were nephrotic and yet responses were high (26). (4) Who should be retreated?…”

Rituximab in Adult Minimal Change Disease and Focal Segmental Glomerulosclerosis

“…Notably, only 8 out of 25 patients had nephrotic range proteinuria at baseline. In their retrospective analysis, Bruchfeld et al [12] observed good efficacy after RTX therapy with achievement of remission in 15 out of 16 MCD patients. In addition, the majority of patients remained relapse-free during a follow-up period of at least 12 months.…”

“…A prospective study from Japan revealed mild infusion reactions such as cough and hiccough, and an exanthema as predominant complications, whereas 1 patient developed mild leukopenia related to RTX during follow-up [11]. Bruchfeld et al [12 ]reported 2 patients suffering from transient hypotension and 1 patient with itchy and red eyes. In their prospective study, Ruggenenti et al [3] observed no immediate side effects, whereas infectious complications such as gastroenteritis, varicella or flu-like syndrome, and noninfectious complications like seizures or melanoma in situ were reported.…”