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Novel use of rituximab for steroid-dependent nephrotic syndrome in children.

Kimata, Takahisa; Hasui, Masafumi; Kino, Jiro; Kitao, Tetsuya; Yamanouchi, Sohsaku; Tsuji, Shoji; Kaneko, Kazunari.
Am J Nephrol; 38(6): 483-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24296765

BACKGROUND:

Though rituximab (RTX) is effective for childhood steroid-dependent nephrotic syndrome (SDNS), an established regimen does not exist. The relapses tend to occur when the peripheral blood B-cell count re-arises at 3 months upon single RTX infusion. This study was conducted to clarify whether the long-term remission of SDNS can be obtained by repeated RTX administrations.

METHODS:

RTX was administered 4 times at 3-month intervals at 375 mg/m(2)/time to 5 children with SDNS. The changes in the clinical indicators were analyzed.

RESULTS:

The median (range) observation period was 6.3 (0.9-8.4) years before RTX and 3.2 (1.9-3.8) years following the commencement of RTX. The changes in the clinical indicators were as follows (median and range) (1) annual number of relapses before administration 1.4 (1.1-3.5) times/year, after administration 0.0 (0.0-0.0) times/year, and (2) median steroid dosage before administration 0.80 (0.23-0.96) mg/kg/day, after administration 0.00 (0.00-0.00) mg/kg/day. All changes were significant at p < 0.05. Relapse occurred 3 times following the start of RTX (the period to relapse was 2.2, 1.9, and 2.3 years, respectively). No serious side effects were seen.

CONCLUSIONS:

Repeated RTX against SDNS in children may be a useful therapeutic option.
Selo DaSilva