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

被引：112

作者：

Kemper, Markus J. ^{[1
]}

Gellermann, Jutta ^{[2
]}

Habbig, Sandra ^{[3
]}

Krmar, Rafael T. ^{[4
]}

Dittrich, Katalin ^{[5
]}

Jungraithmayr, Therese ^{[6
]}

Pape, Lars ^{[7
]}

Patzer, Ludwig ^{[8
]}

Billing, Heiko ^{[9
]}

Weber, Lutz ^{[10
]}

Pohl, Martin ^{[11
]}

Rosenthal, Katrin ^{[12
]}

Rosahl, Anne ^{[1
]}

Mueller-Wiefel, Dirk E. ^{[1
]}

Doetsch, Joerg ^{[3
]}

机构：

[1] Univ Childrens Hosp, Hamburg, Germany

[2] Univ Childrens Hosp, Berlin, Germany

[3] Dept Paediat & Adolsecent Med, Cologne, Germany

[4] Karolinska Univ Hosp, Univ Childrens Hosp, Stockholm, Sweden

[5] Univ Childrens Hosp, Erlangen, Germany

[6] Univ Childrens Hosp, Innsbruck, Austria

[7] Univ Childrens Hosp, Hannover, Germany

[8] St Elisabeth & Barabara Childrens Hosp, Halle, Germany

[9] Univ Childrens Hosp, Heidelberg, Germany

[10] Univ Childrens Hosp, Munich, Germany

[11] Univ Childrens Hosp, Freiburg, Germany

[12] Klinikum Nurnberg, Childrens Hosp, Nurnberg, Germany

来源：

NEPHROLOGY DIALYSIS TRANSPLANTATION | 2012年 / 27卷 / 05期

关键词：

nephrotic syndrome; rituximab; steroid sensitive; MYCOPHENOLATE-MOFETIL; T-CELL; CYCLOSPORINE; RESISTANT; CHILDREN;

D O I：

10.1093/ndt/gfr548

中图分类号：

R3 [基础医学]; R4 [临床医学];

学科分类号：

1001 ; 1002 ; 100602 ;

摘要：

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.

引用

页码：1910 / 1915

页数：6

共 30 条

[1] Change of the course of steroid-dependent nephrotic syndrome after rituximab therapy [J].