Erschienen in:
01.08.2008 | Original Article
Rituximab treatment for severe steroid- or cyclosporine-dependent nephrotic syndrome: a multicentric series of 22 cases
verfasst von:
Vincent Guigonis, Aymeric Dallocchio, Véronique Baudouin, Maud Dehennault, Caroline Hachon-Le Camus, Mickael Afanetti, Jaap Groothoff, Brigitte Llanas, Patrick Niaudet, Hubert Nivet, Natacha Raynaud, Sophie Taque, Pierre Ronco, François Bouissou
Erschienen in:
Pediatric Nephrology
|
Ausgabe 8/2008
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Abstract
Several case reports suggest that rituximab (RTX) could be effective in steroid-dependent nephrotic syndrome, but RTX efficacy has not yet been studied in a series of patients. Safety and efficacy of RTX were assessed in a multicenter series of 22 patients aged 6.3–22 years with severe steroid-dependent nephrotic syndrome or steroid-resistant but cyclosporin-sensitive idiopathic nephrotic syndrome. Patients were treated with two to four infusions of RTX. Seven patients were nephrotic at the time of RTX treatment. Peripheral B cells were depleted in all subjects. Remission was induced in three of the seven proteinuric patients. One or more immunosuppressive (IS) treatments could be withdrawn in 19 patients (85%), with no relapse of proteinuria and without increasing other IS drugs. RTX was effective in all patients when administered during a proteinuria-free period in association with other IS agents. When relapses occurred, they were always associated with an increase in CD19 cell count. Adverse effects were observed in 45% of cases, but most of them were mild and transient. This study suggests that RTX could be an effective treatment for severe steroid-dependent nephrotic syndrome.