The Efficacy and Safety for Single Dose of Rituximab in Children with Steroid Dependent- Minimal Change Nephrotic Syndrome by Two Years

Abstract

Purpose: Exploring efficacy and safety for first single dose of rituximab(RTX) in children with steroid dependent-minimal change nephrotic syndrome(SD-MCNS) by retrospective analysis in two years after RTX and established the model of prediction for relapsing. Methods: Children with SD-MCNS, admitted in our hospital and received single dose of RTX(375mg/m2) by first time from Oct 2011 to Dec 2018, were included. They were followed by 24 months. The clinical and laboratory data before and after RTX were collected and analyzed. Results: 77 patients (M/F: 51/26) were included. The median age was 8.17 years old. The median dependent dosage of steroids was 7.87mg/m2·d. The efficacy for the first single dose of RTX in children with SD-MCNS was 90.91%(70/77), 60 patients (77.9%) for complete remission and 10(13.0%) for partial remission. The relapse rate was 78.3%. There were no severe side effects. Age using RTX, dependent dosage of steroids and CD4+ level before RTX had relationship with efficacy of RTX (B=0.390, -0.091, 0.134, P<0.05). Sex, ageing using RTX, IgE before RTX, WBC and CD3+ when stopping steroids were related to relapsing (B=-1.485, -0.373, 1.278, -0.417, 0.135, P<0.05). The model of prediction for relapsing after RTX in children with SD-MCNS was established.Conclusion: Single dose of RTX is efficiency and safe in children with SD-MCNS, but with high recurrence rate. Patients with older age using RTX, or smaller dependent-dosage of steroids, or higher CD4+ have better efficacy for RTX. Male younger patients with higher IgE relapse more easily.