Ofatumumab for Rituximab- Resistant Nephrotic Syndrome

Cases of the steroid-resistant nephrotic syndrome that are resistant to rituximab can be difficult to treat. In this report, ofatumumab, an anti-CD20 monoclonal antibody, showed some benefit in five young patients.To the Editor: Treatment of children with the steroid-resistant nephrotic syndrome (SRNS) is challenging. During the past decade, rituximab was found to be a promising agent in managing SRNS that was resistant to alkylating agents and calcineurin inhibitors. But increasing evidence of rituximab resistance in patients with SRNS has spurred a search for additional therapies.(1),(2) Patient 1, a 19-year-old girl with a 6-year history of SRNS (in whom focal segmental glomerulosclerosis had been diagnosed), had resistance to all available standard drugs, including two courses of rituximab. After the withdrawal of glucocorticoids, she continued to have nephrotic-range proteinuria (Table 1). ...