title: Ofatumumab for the treatment of childhood nephrotic syndrome.
abstract: Ofatumumab is a humanized anti-CD20 monoclonal antibody that has recently garnered interest as a potential therapeutic agent for nephrotic syndrome. We report our center's experience in administering ofatumumab to five pediatric patients with idiopathic nephrotic syndrome.
  
  
  
  Between March 2015 and November 2016, five patients were treated with ofatumumab. One patient had post-transplant recurrent focal segmental glomerulosclerosis (FSGS) which had been resistant to plasmapheresis and numerous immunosuppressive agents. Four patients had nephrotic syndrome in their native kidneys, one with initial steroid-resistant disease and the others with subsequent development of steroid resistance. Two of the patients were treated with a desensitization protocol after experiencing hypersensitivity reactions to ofatumumab.
  
  
  
  One patient did not complete ofatumumab treatment due to infusion reactions. Of the four remaining patients, three achieved complete remission after treatment, and one achieved partial remission. One of the patients achieving complete remission represents the first reported case of successful treatment of post-transplant recurrent FSGS using ofatumumab. Two patients who received ofatumumab with our desensitization protocol were able to complete their treatments after initially experiencing hypersensitivity reactions.
  
  
  
  Ofatumumab may be an effective treatment for refractory childhood nephrotic syndrome and post-transplant recurrent FSGS. A desensitization protocol may be helpful to address hypersensitivity reactions.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA. chia-shi.wang@emory.edu.|Children's Healthcare of Atlanta, Atlanta, GA, USA. chia-shi.wang@emory.edu.|Division of Pediatric Nephrology, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA, 30322-1015, USA. chia-shi.wang@emory.edu.
authors.forename: Chia-Shi
authors.identifier: 0000-0001-6941-0057
authors.initials: CS
authors.lastname: Wang
authors.affiliation: Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Rochelle Schmidt
authors.initials: RS
authors.lastname: Liverman
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.|Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Rouba
authors.initials: R
authors.lastname: Garro
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.|Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Roshan Punnoose
authors.initials: RP
authors.lastname: George
authors.affiliation: Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Anastacia
authors.initials: A
authors.lastname: Glumova
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.|Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Alana
authors.initials: A
authors.lastname: Karp
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.|Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Jernigan
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.|Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Warshaw
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D004342:Drug Hypersensitivity; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011183:Postoperative Complications / Q000188:drug therapy; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C527517:ofatumumab
keywords: Children; Focal segmental; Glomerulosclerosis; Nephrotic syndrome; Ofatumumab