title: Novel use of rituximab for steroid-dependent nephrotic syndrome in children.
abstract: BACKGROUND
  Though rituximab (RTX) is effective for childhood steroid-dependent nephrotic syndrome (SDNS), an established regimen does not exist. The relapses tend to occur when the peripheral blood B-cell count re-arises at 3 months upon single RTX infusion. This study was conducted to clarify whether the long-term remission of SDNS can be obtained by repeated RTX administrations.
  
  
  METHODS
  RTX was administered 4 times at 3-month intervals at 375 mg/m(2)/time to 5 children with SDNS. The changes in the clinical indicators were analyzed.
  
  
  RESULTS
  The median (range) observation period was 6.3 (0.9-8.4) years before RTX and 3.2 (1.9-3.8) years following the commencement of RTX. The changes in the clinical indicators were as follows (median and range): (1) annual number of relapses: before administration 1.4 (1.1-3.5) times/year, after administration 0.0 (0.0-0.0) times/year, and (2) median steroid dosage: before administration 0.80 (0.23-0.96) mg/kg/day, after administration 0.00 (0.00-0.00) mg/kg/day. All changes were significant at p < 0.05. Relapse occurred 3 times following the start of RTX (the period to relapse was 2.2, 1.9, and 2.3 years, respectively). No serious side effects were seen.
  
  
  CONCLUSIONS
  Repeated RTX against SDNS in children may be a useful therapeutic option.
authors.affiliation: Department of Pediatrics, Kansai Medical University, Osaka, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Kimata
authors.forename: Masafumi
authors.initials: M
authors.lastname: Hasui
authors.forename: Jiro
authors.initials: J
authors.lastname: Kino
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kitao
authors.forename: Sohsaku
authors.initials: S
authors.lastname: Yamanouchi
authors.forename: Shoji
authors.initials: S
authors.lastname: Tsuji
authors.forename: Kazunari
authors.initials: K
authors.lastname: Kaneko
mesh_terms: D000293:Adolescent; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D001402:B-Lymphocytes / Q000187:drug effects; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000276:immunology; D012008:Recurrence; D012074:Remission Induction; D000069283:Rituximab; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D013256:Steroids; D000069283:Rituximab