title: Rituximab in children with steroid-dependent nephrotic syndrome: experience of a tertiary center and review of the literature.
abstract: OBJECTIVE
  Rituximab (RTX) is a new treatment option in children with difficult-to-treat steroid-dependent nephrotic syndrome (SDNS). We evaluated the experience of our tertiary center and reviewed the current literature.
  
  
  METHODS
  This is a retrospective single-center study evaluating the efficacy and safety of RTX in children with difficult-to-treat SDNS. Age at diagnosis, type and duration of immunosuppression, age at administration, dose of RTX, possible adverse events, number of relapses, duration of remission, and B-cell count after administration of RTX were analyzed.
  
  
  RESULTS
  Nine children with a median age at diagnosis of nephrotic syndrome of 4.75 (range 1.33-11.33) years and a median age at administration of RTX of 16.08 (range 3.33-19.25) years were included. Before administration of RTX they had a median number of relapses per year of 1.70 (range 0.82-4.80). At last follow-up (median 2.75 years, range 0.58-3.92), a reduction in the number of relapses per year to 0.26 (range 0-2.18) was noted, despite cessation or lowering the dose of immunosuppressive therapy. Four patients achieved complete remission after the first administration of RTX, four more patients after subsequent doses of RTX. No severe adverse events were noted.
  
  
  CONCLUSIONS
  RTX was an effective and safe therapeutic option in our cohort of children with difficult-to-treat SDNS, resulting in a significant reduction of yearly relapses in the absence of severe adverse events and facilitating the reduction of other immunosuppressive medication.
authors.affiliation: a Department of Pediatric Nephrology , University Hospitals Leuven , Leuven , Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: Van Horebeek
authors.affiliation: a Department of Pediatric Nephrology , University Hospitals Leuven , Leuven , Belgium.
authors.forename: Noël
authors.initials: N
authors.lastname: Knops
authors.affiliation: a Department of Pediatric Nephrology , University Hospitals Leuven , Leuven , Belgium.
authors.forename: Maria
authors.initials: M
authors.lastname: Van Dyck
authors.affiliation: a Department of Pediatric Nephrology , University Hospitals Leuven , Leuven , Belgium.
authors.forename: Elena
authors.initials: E
authors.lastname: Levtchenko
authors.affiliation: a Department of Pediatric Nephrology , University Hospitals Leuven , Leuven , Belgium.
authors.forename: Djalila
authors.initials: D
authors.lastname: Mekahli
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D012008:Recurrence; D000069283:Rituximab / Q000627:therapeutic use*; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D007155:Immunologic Factors; D000069283:Rituximab
keywords: Children; Rituximab; Steroid-dependent nephrotic syndrome