title: Rituximab is an efficient and safe treatment in adults with steroid-dependent minimal change disease.
abstract: Development of steroid dependency in patients with nephrotic syndrome may require a long-term multi-drug therapy at risk of drug toxicity and renal failure. Rituximab treatment reduces the steroid dosage and the need for immunosuppressive therapy in pediatric patients. Here we retrospectively analyze the efficacy and safety of rituximab in adult patients with steroid-dependent minimal change disease. To do this, we analyzed the outcome of all adult patients treated with rituximab for steroid-dependent minimal change nephrotic syndrome over a mean follow-up of 29.5 months (range 5.1-82 months). Seventeen patients with steroid-dependent or frequently relapsing minimal change nephrotic syndrome, unresponsive to several immunosuppressive medications, were treated with rituximab. Eleven patients had no relapses after rituximab infusion (mean follow-up 26.7 months, range 5.1-82 months) and nine of them were able to come off all other immunosuppressive drugs and steroids during follow-up. Six patients relapsed at least once after a mean time of 11.9 months (mean follow-up 34.5 months, range 16.9-50.1 months), but their immunosuppressive drug treatment could be stopped or markedly reduced during this time. No adverse events were recorded. Thus, rituximab is efficient and safe in adult patients suffering from severe steroid-dependent minimal change disease. Prospective randomized trials are needed to confirm this study.
authors: Department of Nephrology, AP-HP, Hôpital Tenon, Service de Néphrologie et Dialyses, Paris, France.
authors: Helene
authors: H
authors: Munyentwali
authors: Khedidja
authors: K
authors: Bouachi
authors: Vincent
authors: V
authors: Audard
authors: Philippe
authors: P
authors: Remy
authors: Philippe
authors: P
authors: Lang
authors: Rachid
authors: R
authors: Mojaat
authors: Georges
authors: G
authors: Deschênes
authors: Pierre M
authors: PM
authors: Ronco
authors: Emmanuelle M
authors: EM
authors: Plaisier
authors: Karine Y
authors: KY
authors: Dahan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D018941:Antigens, CD19 / Q000032:analysis; D018951:Antigens, CD20 / Q000276:immunology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018941:Antigens, CD19; D018951:Antigens, CD20; D007166:Immunosuppressive Agents; D000069283:Rituximab; D011241:Prednisone