Rituximab in steroid-dependent nephrotic syndrome.
Treatment of steroid-dependent nephrotic syndrome, particularly in patients who have failed to respond to multiple immunosuppressive drugs, remains challenging. Rituximab represents a new off-label therapeutic option. Here, we report the use of rituximab in 7 children with steroid-dependent nephrotic syndrome with various histological backgrounds who failed to maintain remission with other immunosuppression regimens. All patients received rituximab infusion, 750 mg/m(2) in 2 doses, 2 weeks apart, and the subsequent doses were adjusted by clinical response. In all patients, complete B-cell depletion was observed after the first course of rituximab. Follow-up for at least 12 months showed sustained remission in 6 children. We conclude that rituximab can reduce the risk of relapses, reduce the burden of immunosuppression, and at least, offer a better control of steroid-dependent nephrotic syndrome with minimal doses of immunosuppressive agents and steroids.
Pediatric Nephrology Unit, Royal Hospital for Sick Children, Glasgow, Scotland, UK. mohamed_197228@hotmail.com.
Mohamed
M
El Koumi
D000293:Adolescent; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018941:Antigens, CD19 / Q000097:blood; D001402:B-Lymphocytes / Q000378:metabolism; D002452:Cell Count; D002648:Child; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000517:prevention & control; D000069283:Rituximab; D055502:Secondary Prevention; D016896:Treatment Outcome
D058846:Antibodies, Monoclonal, Murine-Derived; D018941:Antigens, CD19; D007155:Immunologic Factors; D000069283:Rituximab