Single dose of rituximab in children with steroid-dependent minimal change nephrotic syndrome

Niu, Xiaoling; Sheng, Hao; Wang, Ping; Zhang, Wei; Guo, Guimei; Wu, Ying; Kuang, Xinyu; Zhu, Guoding; Huang, Wenyan

doi:10.3892/br.2016.711

Cited by 10 publications

(16 citation statements)

References 25 publications

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“…The results are similar to other studies were conducted from other facilities. [1][2][3]5 In this study, we demonstrated that Rituximab can be used to decrease the dose of oral steroid in SDNS patients. This finding is consistent with other clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is consistent with other clinical trials. 2,4,6 In Niu et al A single dose of Rituximab was given to 19 patients diagnosed with SDNS, 10 patients went in complete remission and did not relapse within 4-50 months without administration of oral steroid or immunosuppressive therapy. While 9 patients relapsed, but kept on lower dosage of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Rituximab efficacy in pediatric patients with refractory nephrotic syndrome

et al. 2017

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Background: Nephrotic syndrome (NS) in children is a disease of glomerular filtration barrier failure, manifesting with severe proteinuria leading to hypoalbuminemia, hypercholesterolemia, and generalized edema. it could be primary or secondary. In primary NS, also known as idiopathic NS, the histological findings of Primary NS include minimal change disease which mainly respond to steroids (steroid sensitive NS), focal segmental glomerulosclerosis which are usually steroid resistant or membranous nephropathy. Rituximab has been shown to be effective for patients with complicated FRNS/SDNS and refractory SRNS. While the incidence of nephrotic syndrome (NS) is increasing, the morbidity of difficult-to-treat NS is significant.Methods: This is a retrospective cohort study that took place in King Abdulaziz University Hospital from 2012 to 2016. Patients included: Any patient under 18 years, and diagnosed with steroid resistant and dependent nephrotic syndrome. Patients excluded: Any patient above 18 years, and known to have secondary Nephrotic Syndrome.Results: Present study consists of 24 children with nephrotic syndrome (NS) were recruited in the study. In the population 8 patients (33.33 %) were diagnosed with SDNS, while the other 16 patients (66.67%) were diagnosed SRNS. Also, patients who were treated with Rituximab we found that (the mean) number of relapses per year before rituximab was about 2.67±1.49 (standard deviation 1.49), while patient who relapsed after rituximab was about 1.09±1.38 (standard deviation 1.38).Conclusions: Rituximab is a biological agent that started to be widely used in difficult nephrotic syndrome cases. The effectiveness of rituximab is most observed in steroid depended nephrotic syndrome patients since it decreases the frequency of relapses and steroid dependency. However, it has been shown that it is less effective in steroid resistant nephrotic syndrome cases and was associated with significant numbers of relapses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rituximab efficacy in pediatric patients with refractory nephrotic syndrome

et al. 2017

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“…Then, we reviewed full-text of selected articles and removed 49 studies because the topics were not relevant to the subject. Finally, 17 investigations were included in the systematic review (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The flow diagram of study selection is shown in Figure 1.…”

Section: Search Results and Characteristicsmentioning

confidence: 99%

“…Rituximab (RTX) might be a hopeful treatment for refractory NS in children, but the long-term effects and cost-effectiveness of RTX treatment have not been fully assessed (3). Several studies have suggested RTX as a proper drug for the treatment of children with FRNS/SDNS (5)(6)(7)(8). This study aims to perform a systematic review to identify the efficacy and safety of RTX in children with difficult-to-treat NS.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of rituximab in children with difficult-to-treat nephrotic syndrome; a systematic review

Azarfar¹,

Ravanshad²,

Mehrad‐Majd³

et al. 2018

J Renal Inj Prev

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“…However, 42% of the patients who received RTX four times had one or more serious side effects, although most were treatable and no patients died. Thus, Niu et al investigated the efficacy of a single dose of RTX that appeared to have fewer side effects in SDNS 19) . Among 19 patients, 10 remained in complete remission and did not relapse without oral steroids or immunosuppressants for 4-50 months despite recovery of the B cell count.…”

Section: Discussionmentioning

confidence: 99%

Effects of Rituximab Including Long-term Maintenance Therapy in Children with Nephrotic Syndrome in a Single Center of Korea

Kim¹,

Lim²,

Song³

et al. 2018

Child Kidney Dis

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is a chimeric monoclonal antibody that inhibits CD20-mediated B-cell proliferation and differentiation. Several studies have examined its use in intractable nephrotic syndrome (NS) with some positive results. However, those studies examined such effects for a short-term period of 1 year, and some patients continued to relapse after a lapse in RTX treatment. Our use of RTX as a maintenance therapy (RTX injection when the CD19 cell count exceeded 100-200/µL before relapse) showed some noticeable efficacy. We used RTX in 19 patients with steroid-dependent NS (SDNS). In 12 patients treated with RTX maintenance therapy, only one relapse occurred. The mean treatment period was 23.4±12.7 months, and the mean number of RTX administrations was 3.9±1.6. The relapse rates were decreased (from 2.68/year to 0.04/year), and the drug-free period also increased (from 22.5 days/year to 357.1 days/year) during maintenance therapy. The other seven patients were treated with one cycle of RTX or additional cycles in case of relapse (non-maintenance therapy). Relapse rates were significantly decreased after RTX treatment (from 1.76/year to 0.96/year, P=0.017). The relapsefree period was 15.55±7.38 (range, 5.3-30.7) months. No severe side effects of RTX were found except for a hypersensitivity reaction such as fever and chills during its infusion. In conclusion, RTX is considered an effective and safe option to reduce the relapse rate by a single-or maintenance-interval therapy in SDNS.

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Single dose of rituximab in children with steroid-dependent minimal change nephrotic syndrome

Cited by 10 publications

References 25 publications

Rituximab efficacy in pediatric patients with refractory nephrotic syndrome

Rituximab efficacy in pediatric patients with refractory nephrotic syndrome

Efficacy and Safety of rituximab in children with difficult-to-treat nephrotic syndrome; a systematic review

Effects of Rituximab Including Long-term Maintenance Therapy in Children with Nephrotic Syndrome in a Single Center of Korea

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