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Long-term follow-up after rituximab for steroid-dependent idiopathic nephrotic syndrome
- 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.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Nephrotic Syndrome
Long term follow up
medicine.medical_treatment
Kaplan-Meier Estimate
Antibodies, Monoclonal, Murine-Derived
Pharmacotherapy
Refractory
Recurrence
medicine
Humans
Immunologic Factors
Longitudinal Studies
Child
Retrospective Studies
Transplantation
Dose-Response Relationship, Drug
business.industry
Remission Induction
Infant
Immunosuppression
Retrospective cohort study
medicine.disease
Treatment Outcome
Nephrology
Child, Preschool
Monoclonal
Immunology
Drug Therapy, Combination
Female
Steroids
Rituximab
business
Nephrotic syndrome
Follow-Up Studies
medicine.drug
Subjects
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