title: Rituximab in adult patients with immunosuppressive-dependent minimal change disease.
abstract: BACKGROUND
  Minimal change disease (MCD) is one of the leading causes of nephrotic syndrome. Steroid therapy is effective in achieving remission, but relapses, steroid dependence, and steroid resistance are therapeutic challenges. The use of second-line agents such as cyclophosphamide is associated with toxicity and adverse effects. Therefore, we studied the effect of rituximab (RTX) on proteinuria in adult patients with immunosuppressive (IS)-dependent MCD.
  
  
  METHODS
  In this single-center, prospective, open series study, 6 consecutive patients with IS-dependent MCD and frequent relapses on different IS regimens - one of them after previous RTX treatment - were included. Patients were treated with a single dose of RTX (375 mg/m²). An additional dose of RTX was administered depending on B-cell count and proteinuria.
  
  
  RESULTS
  5 out of 6 patients achieved complete remission at the end of the follow-up; the other patient had a partial remission. All patients are free of additional IS agents and other medications were remarkably reduced. Three patients had a relapse, which was successfully treated with a further RTX treatment.
  
  
  CONCLUSIONS
  RTX could be an alternative in the therapy of patients with IS-dependent MCD, leading to successful cessation of other IS treatment.
authors.affiliation: University Medical Center Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Hoxha
authors.forename: R A K
authors.initials: RA
authors.lastname: Stahl
authors.forename: S
authors.initials: S
authors.lastname: Harendza
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D009402:Nephrosis, Lipoid / Q000188:drug therapy* / Q000276:immunology; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy*; D012008:Recurrence; D012074:Remission Induction; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000069283:Rituximab