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Long-term follow-up after rituximab for steroid-dependent idiopathic nephrotic syndrome

Authors :
Lars Pape
Heiko Billing
Jörg Dötsch
Lutz T. Weber
Sandra Habbig
Anne Rosahl
Martin Pohl
Katalin Dittrich
Katrin Rosenthal
Ludwig Patzer
Therese Jungraithmayr
Rafael T. Krmar
Jutta Gellermann
Markus J. Kemper
Dirk E. Mueller-Wiefel
Source :
Nephrology Dialysis Transplantation. 27:1910-1915
Publication Year :
2011
Publisher :
Oxford University Press (OUP), 2011.

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. 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). 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. 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.

Details

ISSN :
14602385 and 09310509
Volume :
27
Database :
OpenAIRE
Journal :
Nephrology Dialysis Transplantation
Accession number :
edsair.doi.dedup.....f3211a34c3ca6579c66ac69b04c853d5
Full Text :
https://doi.org/10.1093/ndt/gfr548