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Long-term follow-up after rituximab for steroid-dependent idiopathic nephrotic syndrome.
- Source :
-
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2012 May; Vol. 27 (5), pp. 1910-5. Date of Electronic Publication: 2011 Nov 09. - Publication Year :
- 2012
-
Abstract
- Background: In patients with refractory steroid-sensitive nephrotic syndrome (SSNS), treatment with rituximab has shown encouraging results; however, long-term follow-up data are not available.<br />Methods: We performed a retrospective analysis of 37 patients (25 boys) with steroid-dependent nephrotic syndrome who were treated with rituximab (375 mg/m(2) given weekly for one to four courses). Long-term follow-up data (>2 years, median 36, range 24-92.8 months) are available for 29 patients (12 boys).<br />Results: Twenty-six of 37 (70.3%) patients remained in remission after 12 months. Relapses occurred in 24 (64.8%) patients after a median of 9.6 (range 5.2-64.1) months. Time to first relapse was significantly shorter in patients receiving one or two compared to three or four initial infusions. In the 29 patients with long-term follow-up for >2 years, 12 (41%) patients remained in remission after the initial rituximab course for >24 months, 7 (24.1%) patients without further maintenance immunosuppression. Nineteen children received two to four repeated courses of rituximab increasing the total number of patients with long-term remission to 20 (69%), remission including 14 (48%) patients off immunosuppression. The proportion of patients with long-term remission was not related to the number of initial rituximab applications. No serious side effects were noted.<br />Conclusion: Rituximab is an effective treatment option in the short- and long-term control of treatment refractory SSNS. Further controlled studies are needed to address optimal patient selection, dose and safety of rituximab infusions.
- Subjects :
- Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Infant
Kaplan-Meier Estimate
Longitudinal Studies
Male
Recurrence
Remission Induction
Retrospective Studies
Rituximab
Treatment Outcome
Antibodies, Monoclonal, Murine-Derived therapeutic use
Immunologic Factors therapeutic use
Nephrotic Syndrome drug therapy
Steroids therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2385
- Volume :
- 27
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
- Publication Type :
- Academic Journal
- Accession number :
- 22076431
- Full Text :
- https://doi.org/10.1093/ndt/gfr548