Risk factors for relapse and long-term outcome in steroid-dependent nephrotic syndrome treated with rituximab

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Koichi KameiShuichi Ito

Abstract

Rituximab (RTX) is known to be effective for the treatment of refractory steroid-dependent nephrotic syndrome (SDNS). However, there are insufficient data on the risk factors for relapse and long-term outcome after RTX treatment. We administered a single dose of RTX to patients with refractory SDNS from November 2007 to December 2013 and continued with immunosuppressants. The risk factors for early relapse and long-term outcome were analyzed. Eighty-one patients were included and the observation period was 13-90 months. Seventy-six patients (94 %) discontinued steroids. Median duration of B-cell depletion was 160 days and 50 % relapse-free survival was 482 days. In multivariate analyses, only a history of steroid-resistant nephrotic syndrome (SRNS) was a statistically significant risk factor (hazard ratio, 2.44; p = 0.048). Fifty percent relapse-free survival in patients without a history of SRNS was 615 days, longer than that of patients with a history of SRNS (393 days) (p=0.005) [corrected]. Fifty-one patients (63 %) received additional RTX treatments for relapses. At last observation, patients using calcineurin inhibitors decreased from 89 % to 23 %, and 12 patients (15 %) discontinued immunosuppressants. Rituximab treatmen...Continue Reading

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Citations

Jul 17, 2016·Clinical and Experimental Nephrology·Kazumoto IijimaKandai Nozu
Aug 26, 2016·Clinical and Experimental Nephrology·Shuichiro FujinagaToshiaki Shimizu
Oct 1, 2016·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Marina VivarelliGianmarco Ghiggeri
Sep 15, 2017·Kidney Research and Clinical Practice·Ji Hyun KimHae Il Cheong
Jul 1, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Koichi KameiUNKNOWN Rituximab for Childhood-Onset Refractory Nephrotic Syndrome (RCRNS) Study Group
Jun 25, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Eugene Yu-Hin Chan, Kjell Tullus
Oct 1, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Mika OkutsuKenji Ishikura
Apr 24, 2017·Clinical and Experimental Nephrology·Mai SatoShuichi Ito
Mar 6, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Federica ZottaFrancesco Emma

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