title: Rituximab in adult patients with multi-relapsing/steroid-dependent minimal change disease and focal segmental glomerulosclerosis: a report of 5 cases.
abstract: BACKGROUND
  Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are common causes of nephrotic syndrome in children and adults. However, frequent relapses, steroid dependence, steroid resistance, and side effects of immunosuppressive therapy remain a therapeutic challenge. Rituximab (RTX) has evolved as an efficacious alternative in childhood MCD/FSGS. We report the effect of RTX in 5 adult patients with multirelapsing/steroid-dependent nephrotic syndrome due to MCD or FSGS.
  
  
  RESULTS
  All five patients treated with RTX achieved sustained complete remission and additional immunosuppression was withdrawn. One patient had a relapse after 23 months, which was successfully treated with a further series of RTX infusion without reinitiation of steroid therapy. Serious adverse events related to RTX therapy were not observed in our patients.
  
  
  CONCLUSIONS
  Our results indicate that RTX is effective and cessation of additional immunosuppressants could be achieved in all patients reported in this study. RTX may be an effective alternative therapy in adult patients with multirelapsing/steroid-dependent nephrotic syndrome due to MCD or FSGS.
authors.affiliation: Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. andreas.kronbichler@i-med.ac.at
authors.forename: Andreas
authors.initials: A
authors.lastname: Kronbichler
authors.forename: Paul
authors.initials: P
authors.lastname: König
authors.forename: Martin
authors.initials: M
authors.lastname: Busch
authors.forename: Gunter
authors.initials: G
authors.lastname: Wolf
authors.forename: Gert
authors.initials: G
authors.lastname: Mayer
authors.forename: Michael
authors.initials: M
authors.lastname: Rudnicki
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D002675:Child, Preschool; D004351:Drug Resistance; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D009402:Nephrosis, Lipoid / Q000139:chemically induced / Q000517:prevention & control*; D009404:Nephrotic Syndrome / Q000139:chemically induced* / Q000188:drug therapy*; D000069283:Rituximab; D055502:Secondary Prevention; D013256:Steroids / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D013256:Steroids; D000069283:Rituximab