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Efficacy and Safety of Rituximab in Children With Steroid- and Cyclosporine-resistant and Steroid- and Cyclosporine-dependent Nephrotic Syndrome.
- Source :
-
Iranian journal of kidney diseases [Iran J Kidney Dis] 2018 Jan; Vol. 12 (1), pp. 27-32. - Publication Year :
- 2018
-
Abstract
- Introduction: There is evidence of the effectiveness of rituximab in treatment of nephrotic syndrome in children. The present study aimed to assess safety and the therapeutic effectiveness of rituximab in steroid- and cyclosporine-resistant pediatric nephrotic syndrome.<br />Materials and Methods: Forty-three children with steroid- and cyclosporine-resistant or steroid- and cyclosporine-dependent noncongenital nephrotic syndrome were included in the study to receive intravenous rituximab, 375 mg/m2/wk, for 4 weeks. The children were followed up for 2 years. Effectiveness was defined as remission of proteinuria in response to rituximab. Side effects of rituximab were monitored.<br />Results: Overall, 23 (57.1%) of the children had steroid- and cyclosporine-resistant nephrotic syndrome, of whom 8 (34.8%) revealed complete response and 3 (13%) revealed partial response. Seven children (16.7%) had late-resistant nephrotic syndrome, of whom 6 (85.7%) revealed complete response and none revealed partial response. Ten children (26.2%) had steroid- and cyclosporine-dependence all of whom revealed complete response to rituximab. Complete response rate was significantly higher in those with drug-dependent pattern than the other groups (P = .002). There was no association between response to rituximab and pathological basis of disease. Side effects were found in 4 patients as leukopenia in 2, alopecia in 1, and eosinophilia in 1.<br />Conclusions: Rituximab is effective for children with nephrotic syndrome with high efficacy and well tolerability, especially in those with steroid- and cyclosporine-dependent nephrotic syndrome.
- Subjects :
- Adolescent
Age Factors
Child
Child, Preschool
Cyclosporine adverse effects
Female
Humans
Immunosuppressive Agents adverse effects
Kidney pathology
Kidney physiopathology
Male
Nephrotic Syndrome diagnosis
Nephrotic Syndrome drug therapy
Nephrotic Syndrome physiopathology
Proteinuria diagnosis
Proteinuria drug therapy
Proteinuria physiopathology
Remission Induction
Rituximab adverse effects
Steroids adverse effects
Time Factors
Treatment Outcome
Cyclosporine therapeutic use
Immunosuppressive Agents therapeutic use
Kidney drug effects
Nephrotic Syndrome congenital
Rituximab therapeutic use
Steroids therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1735-8604
- Volume :
- 12
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Iranian journal of kidney diseases
- Publication Type :
- Academic Journal
- Accession number :
- 29421774