Journal Article

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

Markus J. Kemper, Jutta Gellermann, Sandra Habbig, Rafael T. Krmar, Katalin Dittrich, Therese Jungraithmayr, Lars Pape, Ludwig Patzer, Heiko Billing, Lutz Weber, Martin Pohl, Katrin Rosenthal, Anne Rosahl, Dirk E. Mueller-Wiefel and Jörg Dötsch

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 27, issue 5, pages 1910-1915
Published in print May 2012 | ISSN: 0931-0509
Published online November 2011 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfr548
Long-term follow-up after rituximab for steroid-dependent idiopathic nephrotic syndrome

Show Summary Details

Preview

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/m2 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.

Keywords: nephrotic syndrome; rituximab; steroid sensitive

Journal Article.  3022 words.  Illustrated.

Subjects: Nephrology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.