1. Multicenter analysis of the efficacy and safety of a non‐standard immunosuppressive therapy with rituximab in children with steroid‐resistant nephrotic syndrome
- Author
-
Dorota Drozdz, Anna Medyńska, Anna Moczulska, Magdalena Silska-Dittmar, Przemysław Sikora, Aleksandra Żurowska, Danuta Ostalska-Nowicka, Ilona Olszak-Szot, Beata Bieniaś, Jacek Zachwieja, Marcin Tkaczyk, Roman Stankiewicz, Danuta Zwolińska, Lidia Hyla-Klekot, Anna Rogowska-Kalisz, Grażyna Kucharska, and Magdalena Drozyńska-Duklas
- Subjects
0301 basic medicine ,Pharmacology ,Nephrology ,medicine.medical_specialty ,Proteinuria ,Physiology ,business.industry ,Glomerulonephritis ,medicine.disease ,Discontinuation ,Steroid-resistant nephrotic syndrome ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Prednisone ,030220 oncology & carcinogenesis ,Physiology (medical) ,Internal medicine ,medicine ,Rituximab ,medicine.symptom ,business ,Nephrotic syndrome ,medicine.drug - Abstract
The aim of the study was a multicenter analysis of the efficacy and safety of a non-standard immunosuppressive therapy with rituximab (Rtx) in children with steroid-resistant nephrotic syndrome (SRNS) with particular emphasis on the possibility of permanent discontinuation or dose reduction of other immunosuppressive drugs such as glucocorticoids and cyclosporine A after 6 months of observation. The study group consisted of 30 children with idiopathic nephrotic syndrome, who were unresponsive to standard immunosuppressive treatment, and hospitalized in the years 2010-2017 in eight paediatric nephrology centres in Poland. The children were administered a single initial infusion of rituximab at the dose of 375 mg/m2 of the body surface area. Proteinuria, the daily supply of glucocorticoids, and cyclosporine were assessed at the moment of the start of the treatment and after 6 months since its commencement. Before Rtx therapy, complete remission was found in 13 patients (43%) and partial remission was found in 8 patients (26%). These numbers increased to 16 (53%) and 12 (40%), respectively. At the start of the treatment 23 patients (76.6%) were treated with cyclosporine A. After 6 months, this number decreased to 15 patients (35%). At the start of the treatment, 18 patients (60%) were treated with prednisone. After 6 months, this number decreased to 8 patients (44%). Children with SRNS may potentially benefit from Rtx treatment despite relative risk of side effects. The benefits may include reduction of proteinuria or reduction of other immunosuppressants.
- Published
- 2018